Patients 

This involves the knee in which the cartilage defect is located being opened up with small chisels. The opening allows blood, bone marrow and stem cells to enter the defect and fill it with scar tissue, creating a replacement or "fibro” cartilage. This replacement cartilage is however fundamentally different from the original joint cartilage both biologically and in terms of tissue structure. For example, it is far less resilient. For this reason, microfracturing should only be used for minor cartilage defects. The principle advantage of the treatment is that it is minimally invasive and only needs to be carried out once.

Autologous osteochondral cylinder transplantation, also known as mosaic plastics, OCT and OATS, is a procedure during which cartilage/bone cylinder is taken from a less stressed part of the joint and inserted into the defect area. This enables a larger part of the defect to be covered with hyaline joint cartilage. However, less resilient fibrocartilage forms in the gaps between the cylinders, resulting in the formation of mixed cartilage tissue. As cartilage bone punches need to be extracted from non-stressed areas, this treatment is also restricted to smaller defects. If too much donor cylinder is taken to cover the defect, cartilage defects at the extraction site can lead to painful arthrosis. Such cases are referred to as “donor site morbidity”.

ACT is the only procedure to enable even larger defect surfaces to be biologically reconstructed, without an increased risk of donor site morbidity. It involves the taking of a small amount of cartilage from a non load-bearing joint area by way of arthroscopy.
The cartilage extracted is taken to our GMP-compliant cleanroom laboratories, where it is prepared. The cells contained in the cartilage (chondrocytes) are isolated from their basic substance and multiplied in cell culture flasks. When the cell count required for the defect area in question is reached, the chondrocytes are seeded in a support material, where they begin to produce cartilage ground substance. The individual implant created is then ready for transplantation after precisely three weeks.
Unlike conventional ACT (in which a flap of bone is stitched over the prepared defect, beneath which the cells are then injected in an aqueous solution), once it has been punched out using special OP instruments in a size and shape matching that of the defect, the cell-populated NOVOCART® 3D carrier material can then simply be inserted into it.  With this form of ACT, there is also no need for time-intensive, watertight stitching, as the carrier is fixed with just a few stitches. The result is a significant reduction in OP time with carrier-coupled ACT. The biomaterial used by TETEC has been developed especially for human cartilage cells and this possesses unique properties when compared to other biomaterials used throughout the world.
Research conducted to date with over 400 patients treated with ACT using our innovative biomaterial shows in particular that a significant reduction has been achieved in complication rates, when compared to the conventional form of ACT – and with, in most cases, equally good clinical results. The procedure itself is much faster and the rehabilitation phase shorter, with the result that in recent years, the matrix-coupled form of ACT using NOVOCART® 3D has become increasingly popular.