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Autologe Chondrozytentransplantation zur Behandlung von Knorpeldefekten des Kniegelenks

Techniken und Ergebnisse

Autologous chondrocyte transplantation for the treatment of articular cartilage defects inf the knee joint: techniques and results

  • Knorpeltransplantation
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Zusammenfassung

Hintergrund

Zur Behandlung umschriebener Defekte des artikulären Kniegelenkgelenkknorpels wird der Einsatz autologer Knorpelzellen zunehmend als neue biologische Methode empfohlen.

Methoden

Die Technik der autologen Chondrozytentransplantation (ACT) und deren Modifikationen als matrixassoziierte autologe Chondrozytentransplantation (MACT) werden dargestellt. Es erfolgt ein Überblick über die experimentellen und klinischen Ergebnisse mit der Darstellung der häufigsten Komplikationen und den derzeit gültigen Indikationsrichtlinien.

Ergebnisse

Unter Verwendung qualitativ hochwertiger Zellen zeigen besonders posttraumatische Knorpeldefekte bei jüngeren Patienten eine hohe Erfolgsquote mit der Ausbildung eines hyalinartigen Regeneratgewebes. Die häufigsten Komplikationen der ACT sind Periosthypertrophie, Delamination des Transplantats, intraartikuläre Adhäsionen und Transplantatversagen. Die derzeit wichtigsten Limitierungen stellen die Osteoarthrose und ein höheres Patientenalter dar.

Schlussfolgerungen

Bei richtiger Indikationsstellung und operativer Technik kann die ACT als effiziente und sichere Therapieoption für die Behandlung großer und tiefer Knorpeldefekte des Kniegelenks angesehen werden.

Abstract

Background

Currently the use of autologous chondrocytes as a cartilage-repair procedure for the repair of injured articular cartilage of the knee joint, is recommended.

Methods

This review presents the technique of autologous chonrocyte transplantation (ACT) and their modifications as matrix-associated autologous chondrocyte transplantation (MACT). Beside the surgical procedure the experimental and clinical results are discussed. Furthermore the major complications and the indication guidelines are presented.

Results

Articular cartilage in adults has a poor ability to self-repair after a substantial injury. Surgical therapeutic efforts in treating cartilage defects have focused on bringing new cells capable of chondrogenesis into the lesions. With ACT good to excellent clinical results are seen in isolated posttraumatic lesions of the knee joint in the younger patient with the formation of hyalinelike repair tissue. The major complications are periosteal hypertrophy, delamination of the transplant, arthrofibrosis and transplant failure. The current limitations include osteoarthritic defects and higher patient age.

Conclusion

With the right indication and operative technique ACT is an effective and save option for the treatment of large full thickness cartilage defect of the knee joint.

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Authors and Affiliations

  1. Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien

    S. Marlovits, F. Kutscha-Lissberg, S. Aldrian, C. Resinger, P. Singer, P. Zeller & V. Vécsei

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

    S. Marlovits

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  1. S. Marlovits
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  2. F. Kutscha-Lissberg
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Correspondence to S. Marlovits.

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Gefördert durch die Lorenz-Böhler-Gesellschaft (Projekt 96/5 und 02/10).

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Marlovits, S., Kutscha-Lissberg, F., Aldrian, S. et al. Autologe Chondrozytentransplantation zur Behandlung von Knorpeldefekten des Kniegelenks. Radiologe 44, 763–772 (2004). https://doi.org/10.1007/s00117-004-1082-0

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