Article

The high clinical and socio-economical impact of cartilage defects and chondral degeneration is well known. A golden standard for the treatment of cartilage defects does not exist. Superficial lacerations of the joint cartilage do not have a tendency toward self healing but seem to stay stationary in many cases. Full thickness cartilage defects down to the subchondral bone plate or beyond have a proven tendency toward progression and therefore require a specific treatment. Since joint instability and unphysiological joint axes are cofactors for cartilage lesions, deformities and instability have to be corrected prior to cartilage-specific treatment. Various techniques for the regeneration of articular cartilage promise a physiological repair of even full thickness defects. Bone marrow stimulating procedures such as drilling, abrasion and microfracture induce the ingrowth of stemcells and fibroblasts into the defect with the anticipated result of a cartilage regeneration with fibrous tissue. To synthesize hyaline cartilage matrix, autologous chondrocytes are cultured in vitro before being delivered into cartilage defects under a periostal flap Autologous chondrocyte implantation has shown promising clinical results for up to 10 years. Osteochondral transplantations (e.g., mosaicplasty) do not represent a cartilage regeneration technique but are widely used for the treatment of smaller defects. New developments regarding the delivery of cells, e.g., in bioresorbable scaffolds enable the arthroscopic implantation of cultured cells.

Langue : ALLEMAND

Tiré à part : OUI

Identifiant basis : 2002224524