How are you? It is a pleasure to be here with you. I represent myself in the catalytic management of leg injuries in sport. I work at the Italian Hospital in Buenos Aires. This is my team. We work in Argentina, the southeast of South America. I have no conflict of interest. As you know, catalytic joint injury is a very common injury. Most of them are asymptomatic but when the patient has pain, blockage, disability, we have to treat it. So we take into account the etiology, the size and the mortality of the lesion. I will talk about focal joint defects. Most of them are the femoracondyle, followed by the patella and the trochlea. If we eliminate osteoarthritis, 68% are focal defects. Almost 90% of the defects are more than 4 square centimeters. As you can see to your left, From the start, we have focused on correcting comorbidities such as malalignment, meniscal status, and ligament stability. The purpose of this presentation was to discuss and share different treatment options for joint injuries in sports. Depending on these factors, conservative treatment with activity modification and weight normalization It is the first line of treatment. But if we fail the microstructure generates a 65% improvement. It is better in patients under 40 years of age with low demand for sports. We suggest that the wound could provide superior results to the use of anoles. In this particular case, it is the OCD with open feces. We believe that it is a very good treatment option. Regarding the injuries, We indicate that in Yang's active grade 4 lesions, as you can see, most of the literature after 10 years has 80% good results. Regarding the surgical technique, first we identify the wound, then the wound, then we cultivate the spelling of dono, we prefer the lateral trochlea, then we make the container socket, the size of the wound, as you can see in this video, and finally we place the graph of the bone. It must not remain extruded. I present an unusual case. This is a 19 year old girl field soccer player, who was referred to our hospital after an encectomy and an infection. You can see that she is a fine woman with a neutral alignment. The infection was cured, the wound was normal but continued with the medial wound. The infection was cured, the wound was normal but continued with the medial wound. The infection was cured, but continued with the medial wound in the warm medial plate, as can be seen on MRI and CT, and was unable to continue playing soccer. In this particular case, we performed a retrograde wound. In this technique, dono's spelling it will be taken at 55 degrees, and the graph will be taken at 55 degrees, and the spelling This is how you can see the follow-up, two years later, with the incorporation of graphite. Here you have two comparative studies between the waves and the microstructures and conclude that the waves produced better results than the microstructures, they also had fewer operations. In another scenario, when we have a free fragment, the surgeon has to decide whether to fix it or not. It depends on the viability of the fragment and the size of the subcontral ball. In this case, we fix it. We have experience in our team and published this paper. And we conclude, after the MRI, the post-op and the second examination, that it is an effective method of OCD repair of the wave. We also published with Dr. Mongeat, from Spain, in 2019, this series of patients. And we conclude that clinical results and a high level of healing, regardless of the size of the lesion and the type of fixation, it is better that there are no problems with the use of a metal waistband or a bio waistband. So, what about the biological and surgical alternative in these large lesions? We have different techniques. Unfortunately, we are not available in Argentina. So, for this technique, we have no experience. However, we have experience with cold allography of osteochondrals. In this case, a 26-year-old man, a motorcyclist, has a large medial femoral condal lesion, and we performed a cold allography of osteochondrals. As you can see here right away, two years later, you see a nice addition of allography in excess. In a similar case, this refers to the fact that, after two false surgeries, we performed a cold allography of osteochondrals, as you can see in these images. We have some experience with atelocollagenesis. This technique has three steps, healing, microstructures, and then the lesion can be felt with atelocollagenesis. In this rare case, in this particular case, it's a 59-year-old man, and he is a fanatical runner, and rejects any piece of metal on his skin. So we do this technique in an open way, and we cover the entire lesion, as you can see in this video. In the follow-up, before and after surgery, the sensation of the injury can be seen, and the patient was very happy with the results, and returned to sports. In conclusion, atelocollagenesis and microstructures improve the clinical outcome in this small series that we publish. Similar approach in patellofemoral injuries, but we have to consider patellofemoral treatment, and we also have to prepare, if we have to fix, like this patient, we fix it with a biosolve waist. If we lack the biological treatment, we have good experience with this resurrection implant, as you can see, it is a small prosthesis, and cemented with good results. To conclude, we are the Comboera, with cartilage resurrection techniques, in addition to other procedures. In conclusion, the natural history of untreated focal article defects is known to be poor. The size, location of the lesion, level of activity, They are guidelines for treatment. Therefore, the doctor must indicate and perform the appropriate surgical treatment to avoid a future foot atroplasty. In general, protect the cartilaginous joint. Thank you very much for your attention, and I hope to see you in Buenos Aires, in the next meeting, combined with the SESM. Thank you so much.

leg injuries

joint injuries

surgical techniques

microstructure treatments

Buenos Aires