Aktuelle Behandlung des Knorpelschadens im Patellofemoralgelenk

Abstract

Joint cartilage damage in adults has practically no tendency to self healing. Symptomatic grade III/IV damage requires surgical treatment. There are special challenges involved in cartilage damage in the patellofemoral joint as the complicated biomechanics of the joint is often combined with dysplasia. All tissue regeneration measures are based on the recruitment of cells. The synovial cells available in the joint can be differentiated to fibrous cartilage under certain mechanical conditions; however, they cannot sufficiently fill in defects. Also the use of bone marrow cells for cartilage reconstruction only creates mechanically inferior fibrous cartilage (Pridie drillings, microfracture, AMIC). Presently only cultivated, autologous chondrocytes from the lab are available for a biomechanically high-quality reconstruction of the cartilage layer.The application of mesenchymal stem cells is a subject of extensive international research. However, the first experimental studies, after initial formation of cartilage, disappointingly show significant ossification. Essential conditions for a successful treatment of patellofemoral cartilage damage are the diagnosis of accompanying pathological conditions, selection of the right cartilage-regenerating procedure, sufficient removal of the basic pathological defect, and implementation of standardized rehabilitation.

New Method of Autoplasty of Knee Articular Surface Defects in Patients With Destructive-Dystrophic Diseases

“…Keywords: knee joint, hyaline cartilage defect, destructive-dystrophic diseases, autoplasty. введеНие С реди больных с деструктивно-дистрофическими заболеваниями коленного сустава формирование дефектов суставной поверхности бедра и большеберцовой кости встречается в 23-37% случаев [1,2,3].…”

Cartilage and Bone Regeneration—How Close Are We to Bedside?

“…[102][103][104] However, there are more MSCs niches with potential to be used for cartilage and bone differentiation, 105 as umbilical cord-and adipose-derived stem cells (ASCs). 114 A novel approach to enhance cartilage repair with AMIC is to deliver GFs that selectively recruit and stimulate MSCs from the subchondral BM to invade cell-free scaffolds. 106,107 Hoffa's body, which is a fat pad of ASCs, has to be removed during an arthroscopy to facilitate the visualization of the knee and surgery handling, and also to avoid tissue inflammation as was explained before.…”