New York State Medical Treatment Guidelines for
Chondral Defects in workers compensation patients
The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Chondral Defects.
These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.
The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.
Description and Definition of Chondral Defects
Cartilage or cartilage and bone defect at the articular or meniscal surface of a joint.
Mechanism of Injury
Usually caused by a traumatic knee injury, particularly as a result of contusion.
Testing Procedures of Chondral Defects
MRI, Radiographs, CT
MRI, Radiographs, CT are recommended in select patients as clinically indicated.
There are several different kinds of injuries in the knee. The most common is a small bump on the outside of your knee, called a meniscus tear. If you have that kind of injury, an MRI will show up as bone bruising or a small area of missing cartilage.
Non-Operative Treatment
Non-Operative Treatment is recommended In some patients
Rest/restricted activity, crutches or a cane, ice packs, elevation of the legs and bracing can help with pain. Active and/or passive therapy can help as well as NSAIDs if needed. APAP therapeutic injections may also be used at a later date if needed.
Surgical Indications and Operative Treatment of Chondral Defects
The list of pre authorised procedures does not include osteochondral autograft and autologous chondrocyte implantation.
To perform one of these procedures, providers must request pre-authorization from their carriers before beginning the procedure. Refer to Table 3 for criteria.
If non-operative treatment is initially recommended, surgery may be indicated if the patient fails to improve with conservative management. The patient must continue to display the designated objective findings, subjective symptoms, and (where applicable) imaging findings.
Autologous Chondrocyte Implantation (ACI) Exclusion Criteria of Chondral Defects
The ACI procedure is not covered if any of the following apply:
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A lesion of the patellofemoral joint cartilage involves any portion of the articular cartilage, bone, or both. It is a common result of osteochondritis dissecans.
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A kissing lesion, which is a milder form of a modified outerbridge grade II, III, or IV, exists on the opposite tibial surface.
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Joint pain that appears on an x-ray as joint space narrowing, osteophytes, or changes in the underlying bone.
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Unhealthy cartilage border; the synovial membrane may be used as a substitute border for up to ¼ of the total circumference.
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The operation must be performed on both the meniscal cartilage of the affected knee and on at least 1/3 of the posterior meniscal rim.
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Anaphylaxis to gentamicin or sensitivity to bovine products can occur.
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Chondrocalcinosis is diagnosed during the cell culture process. The lab will test your blood and determine whether or not you have a type of bacteria that can cause this condition.
Post-Operative Therapy of Chondral Defects
Depending on the patient’s condition, conservative therapy may include restricted weight-bearing, bracing, active and/or passive therapy. This would include continuous passive movement once microfracture surgery has been performed.
What our office can do if you have workers compensation injuries
We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.
We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.
We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.
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NY MTG for Knee
- General Guideline Principles for Triceps Tendinosis (or Tendinitis) and Tears/Ruptures for workers compensation patients
- New York State Medical Treatment Guidelines for Therapy: Ongoing Maintenance Care in workers compensation patients
- New York State Medical Treatment Guidelines for Therapeutic Procedures in workers compensation patients
- New York State Medical Treatment Guidelines for Tendinitis/ Tenosynovitis in workers compensation patients
- New York State Medical Treatment Guidelines for Retropatellar Pain Syndrome in workers compensation patients
- New York State Medical Treatment Guidelines for Knee Rehabilitation in workers compensation patients
- New York State Medical Treatment Guidelines for Radiographic Imaging in workers compensation patients
- New York State Medical Treatment Guidelines for Posterior Cruciate Ligament in workers compensation patients
- New York State Medical Treatment Guidelines for Patellar Subluxation in workers compensation patients
- New York State Medical Treatment Guidelines for Other Procedures in workers compensation patients
- New York State Medical Treatment Guidelines for Orthotics and Prosthetics in workers compensation patients
- New York State Medical Treatment Guidelines for Meniscus Injury in workers compensation patients
- New York State Medical Treatment Guidelines for Meniscal Allograft Transplantation Exclusion Criteria in workers compensation patients
- New York State Medical Treatment Guidelines for Medications in workers compensation patients
- New York State Medical Treatment Guidelines for Laboratory Testing in workers compensation patients
- New York State Medical Treatment Guidelines for Therapeutic Injections in workers compensation patients
- New York State Medical Treatment Guidelines for History Taking and Physical Examination in workers compensation patients
- General Guideline Principles for Knee Injury for workers compensation patients
- New York State Medical Treatment Guidelines for Diagnostic Testing and Procedures of Knee Injury in workers compensation patients
- New York State Medical Treatment Guidelines for Collateral Ligament Injury in workers compensation patients
- New York State Medical Treatment Guidelines for Chondral Defects in workers compensation patients
- New York State Medical Treatment Guidelines for Bursitis in workers compensation patients
- New York State Medical Treatment Guidelines for Anterior Cruciate Ligament in workers compensation patients
- New York State Medical Treatment Guidelines for Aggravated Osteoarthritis in workers compensation patients
- New York State Medical Treatment Guidelines for Acupuncture in workers compensation patients
- New York State Medical Treatment Guidelines for Acupuncture in workers compensation patients
Workers Compensation
- Workers Comp Main Hub
- Workers Comp FAQs
- Medical Treatment Guidelines (MTGs)
- COVID-19 and Workers’ Compensation
- Workers’ Compensation Provider Billing FAQs
- Settling Your Workers’ Compensation Claim
- Short-Term Disability Workers’ Compensation Patients and Paid Family Leave
- The Role of Medical Providers in Workers’ Compensation
- When Should Employers Purchase Workers’ Compensation Insurance?
- Workers’ Compensation Injury Billing Forms
- Workers’ Compensation Insurance: What a Business Owner Needs to Know
- Scheduled Loss of Use
- Scheduled Loss of Use for Hand and Wrist
- Scheduled Loss of Use for Ankle and Foot
- Scheduled Loss of Use for Elbow
- Scheduled Loss of Use for Great and Lesser Toes
- Scheduled Loss of Use for Determining Hip and Femoral Impairment
- Scheduled Loss of Use for Knee and Tibia
- Scheduled Loss of Use for Shoulder
- Scheduled Loss of Use for Upper Extremities – Thumb and Fingers
- Scheduled Loss of Use for Visual System/Auditory System/Facial Scars and Disfigurement
- Scheduled Loss of Use for Central Nervous System Conditions, Peripheral Nerve Injuries and Entrapment / Compression Neuropathies
- Workers’ Compensation Fraud
- Workers’ Compensation State Laws
- Workers’ Compensation Pays Primary to Medicare When a Medicare Beneficiary Has a Work-Related Medical Claim
- Workers’ Compensation Origin
- Workers’ Compensation Issues of Concern, Clinical Significance and Enhancing Healthcare Team Outcomes
- Workers’ Compensation History in the United States
- The Effect of Workers’ Compensation Status on the Patient Experience
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I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.
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