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Therapieoptionen zur Behandlung von Knorpelschäden: Techniken und Indikationen

Therapeutic options in the treatment of cartilage defects: techniques and indications

  • Knorpeltransplantation
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Zusammenfassung

Hintergrund

Das artikuläre Knorpelgewebe besteht aus einer einzelnen Zellpopulation, integriert in ein dreidimensionales Netzwerk hochorganisierter Matrixstrukturen. Dieser feingewebliche Aufbau bestimmt die einzigartigen mechanischen Eigenschaften, limitiert aber auch die physiologischen Reparationsmöglichkeiten von Knorpeldefekten.

Methoden

Diese Übersicht beschreibt die Grundlagen der Knorpelbiologie und die Mechanismen der Knorpelreparatur und behandelt die klinischen Ergebnisse chirurgischer Techniken zur Therapie umschriebener Knorpeldefekte.

Ergebnisse

Die chirurgischen Techniken zur Therapie lokalisierter Defekte der Gelenkoberfläche versuchen durch die Integration biologischer Mechanismen die mangelnde Regenerationsfähigkeit artikulären Knorpels zu überwinden. Die Techniken der Transplantation chondrogener Gewebe wurden in jüngster Zeit durch die Defektauffüllung mit autologen Chondrozyten erweitert.

Schlussfolgerungen

Eine klare Indikationsstellung und die zusätzliche Beseitigung von Bandinstabilitäten und Achsenfehlstellungen sind für jede knorpelchirurgische Therapieform unerlässlich.

Abstract

Background

Cartilage is composed of chondrocytes embedded within an extracellular matrix of collagens, proteoglycans, and noncollagenous proteins. Together, these structures maintain the unique mechanical properties and manifest its striking inability to heal even the most minor injury.

Methods

This review presents the principles of cartilage structure and the biological background of cartilage repair and gives information about the surgical techniques for treating cartilage defects.

Results

The response of cartilage to injuries differs from that of other tissues because of its avascularity, the immobility of chondrocytes and the limited ability of mature chondrocytes to proliferate and alter their synthetic patterns. Surgical therapeutic efforts in treating cartilage defects have focused on bringing new cells and tissues capable of chondrogenesis into the lesions and facilitating the access to the vascular system.

Conclusion

The right indication and the treatment of joint instability and axis deformation are essential for the successful use of cartilage repair procedures.

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Authors and Affiliations

  1. Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien

    C. Resinger, V. Vécsei & S. Marlovits

  2. Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien, Währinger Gürtel 18–20, 1090 , Wien, Österreich

    C. Resinger

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Resinger, C., Vécsei, V. & Marlovits, S. Therapieoptionen zur Behandlung von Knorpelschäden: Techniken und Indikationen. Radiologe 44, 756–762 (2004). https://doi.org/10.1007/s00117-004-1081-1

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