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Severe posttraumatic radiocarpal cartilage damage: first report of autologous chondrocyte implantation

  • Handsurgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Study design

Case report.

Clinical question

Traumatic articular cartilage defects predispose to secondary osteoarthritis accompanied by impairment or complete loss of function in the corresponding joint. On this account, the timely and correct diagnosis as well as the selection of an appropriate therapy for reconstruction of articular cartilage defects is important.

Methods

A 22-year-old healthy male patient with history of traumatic intra-articular distal radius fracture is presented with in the course detectable 4° cartilage damage in the fovea scaphoidea and into the fovea lunata. For the first time, autologous chondrocyte implantation by the use of an in situ polymerizable albumin–hyaluronic acid gel was performed to restore the articular cartilage.

Results

The assessment 6 months after autologous chondrocyte implantation using the standard DASH questionnaire for upper extremity pointed out an improvement in the patient outcome (DASH score pre-operative: 10.8 and 6 months post-operative: 7.5). The clinical examination also showed an improvement in the range of movement of the wrist without pain. The radiological control investigation (MRI- examination) of the wrist 6 months after implantation also revealed a good integration of the implant.

Conclusion

The case presented here demonstrates the first use of autologous chondrocyte implantation for cartilage reconstruction using an in situ polymerizable albumin–hyaluronic acid gel after traumatic cartilage lesion with 4° cartilage damage of the wrist in a 22-year-old non-smoking, active and healthy man. Initial results are promising in terms of mobility, pain and patient outcome. However, further clinical studies have to be performed with larger number of cases.

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Acknowledgments

The authors thank Dr. JM Rothenberger and Dr. A Rahmanian-Schwarz for their excellent support of this work.

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Authors and Affiliations

  1. Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University, Schnarrenbergstr. 95, 72076, Tübingen, Germany

    F. Medved, P. Gonser, O. Lotter, A. Amr & H. E. Schaller

  2. Department of Traumatology and Reconstructive Surgery, BG-Trauma Center, Eberhard Karls University, Schnarrenbergstr. 95, 72076, Tübingen, Germany

    D. Albrecht

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  1. F. Medved
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  2. P. Gonser
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  6. H. E. Schaller
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Correspondence to F. Medved.

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Medved, F., Gonser, P., Lotter, O. et al. Severe posttraumatic radiocarpal cartilage damage: first report of autologous chondrocyte implantation. Arch Orthop Trauma Surg 133, 1469–1475 (2013). https://doi.org/10.1007/s00402-013-1821-7

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  • DOI: https://doi.org/10.1007/s00402-013-1821-7

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