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Around 30,000 treatments of knee cartilage defects are performed annually in Germany alone – the nature and severity of the defects vary. Autologous cartilage cell implantation is promising in the case of full-thickness and symptomatic cartilage defects surrounded by healthy cartilage.
If, on the other hand, the cartilage is worn over a large area and other areas of the knee are also affected, the patient has osteoarthritis. Patients with advanced osteoarthritis are no longer candidates for biological cartilage reconstruction and require a different treatment, even including artificial joint replacement.
Individual factors for choosing the right therapy
As with many injuries, illnesses and therapies: Individual factors also play an important role in the question of matrix-associated autologous chondrocyte implantation (M-ACI). In addition to the cartilage's properties, the decision on the most suitable therapy is also affected by a range of criteria, including the following:
- Previous treatments
- Biological age – this is more important than the calendar age (the focus is on the condition of the cartilage surface and the joint as a whole)
- The patient's physical and sporting activities
- Lifestyle (e.g. smoking, dietary habits)
Indications in detail
This cartilage damage and these conditions may indicate matrix-supported chondrocyte implantation in the knee:
Grade III–IV symptomatic chondral and osteochondral cartilage defects (ICRS classification) up to 2 cm² in size
This refers to cartilage defects that cause symptomatic pain. This damage can either:
- extend up to the bone (chondral)
- or even affect the underlying bone (osteochondral).
Focal, traumatic knee defects
Localised (not diffuse, which would affect the whole knee) damage (focal) caused by an impact or fall etc. (traumatic).
Defined bone areas of the joint surface with the overlying cartilage are dead or have become detached.
Closed epiphyseal plates
These are also called growth plates: cartilage space between the bone shaft and the end of the bone. In children and adolescents, these plates are open to ensure longitudinal growth. They close at the age of around 16 years.
The focus here is on the cruciate ligaments, the menisci and patellar tendon. These should be largely intact.
Intact/partially resected meniscus
Leg axis deviation <3°
The leg axis is measured by X-ray with the patient standing. If the legs are O or X-shaped, the patient has an axis deviation that may have to be corrected surgically.
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|Autologous chondrocyte implantation, also known as autologous chondrocyte implantation or autologous cartilage cell implantation. This procedure is used to treat cartilage damage. Autologous cartilage cells are collected, cultured in a nutrient solution and inserted into the patient’s cartilage defect in order to reduce the discomfort caused by the cartilage damage and prevent the development of osteoarthrosis.
|Also commonly referred to as: matrix-coupled, matrix-supported or matrix-induced autologous chondrocyte implantation (M-ACI). In the M-ACI procedure, the cultivated autologous cartilage cells are implanted into the defective cartilage area using a carrier medium, such as a collagen matrix or a hydrogel.
|From the same body
|Retention (of implanted cells) in the desired position in the body