PubMed · 14909021
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P DE VULPIAN, F KIRSCH. 1951. [Osteochondropathies].. https://pubmed.ncbi.nlm.nih.gov/14909021/
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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 chondrocyte 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 hyaline-like 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.
Over the past decade a number of surgical interventions for durable cartilage repair have been developed. For the long-term follow-up of this procedures clinical scores and the morphological and biochemical evaluation of biopsies taken during arthroscopy are used.Magnetic resonance imaging is a useful noninvasive tool for the evaluation of the morphologic status of the cartilage repair tissue throughout the postoperative period. The MR imaging appearance of the most important cartilage transplantation techniques, such as autologous osteochondral transplantation, autologous chondrocyte implantation and matrix-based autologous chondrocyte implantation are described and possible complications of each technique are mentioned. The importance of new MR techniques such as high-resolution morphologic imaging and possible visualization of biochemical information of cartilage repair tissue is discussed.
Lesions of the TFCC are currently a diagnostic and therapeutic challenge. Disc-injuries are often not identified and, therefore, acute ruptures are unfortunately not always immediately repaired. Moreover, therapeutic measures are still sparse and informative trial results are lacking. An anatomical, pathological, diagnostic and therapeutic comparison with the meniscus of the knee is possible.