Das Minced-Cartilage-Verfahren zur Therapie azetabulärer Knorpelschäden am Hüftgelenk

Zimmerer, Alexander; Gebhardt, Sebastian; Kinkel, Stefan; Sobau, Christian

doi:10.1007/s00064-022-00796-1

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Two minutes was allowed to achieve primary cartilage and thrombin clot stability before an ACP-thrombin mixture was applied on top of the implanted tissue as described elsewhere. 15 …”

Section: Methodsmentioning

confidence: 99%

“… 14 Recently, the practicability of this evolved MCI technique to treat cartilage defects at the acetabulum during hip arthroscopy has been described. 15 In the context of FAIS, cartilage lesions are typically observed as an acetabular cartilage lamella, which is well suited to be harvested by an arthroscopic shaver and serves as an ideal source for subsequent MCI as high viability of chondrocyte acetabular lamellae has been documented in the past. 16 In addition, good viability has also been demonstrated for the cartilage overlying the femoral cam morphology, 16 , 17 which can serve as a secondary source of cartilage tissue during arthroscopic femoroplasty and concomitant MCI.…”

Section: Introductionmentioning

confidence: 99%

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Minced Cartilage Implantation in Acetabular Cartilage Defects: Case Series with 2-Year Results

et al. 2023

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Objective The objective was to evaluate clinical outcome and safety of arthroscopic, autologous minced cartilage implantation for acetabular cartilage lesions observed during hip arthroscopy to treat femoroacetabular impingement syndrome (FAIS). Design Eleven male patients, average age: 29.4 ± 5.4 years, average body mass index (BMI): 24.2 ± 2.2 kg/m2, scheduled for hip arthroscopy due to FAIS accompanied by an acetabular cartilage lesion were included in the case series. Cartilage tissue was harvested and minced from the loose cartilage flap at the chondrolabral lesion by arthroscopic shaver, augmented with autologous conditioned plasma, implanted into the defect, and fixated by autologous thrombin. Concomitant interventions were performed as indicated. The patients were evaluated preoperatively and at 24-month follow-up, using the International Hip Outcome Tool-12 (iHOT-12) and Visual Analog Scale (VAS) pain score and by magnetic resonance imaging (MRI) using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) grading scale at the 2-year follow-up. Results The defect size was on average 3.5 cm2 (1.5-4.5 cm2). From preoperatively to 2 years postoperatively, the iHOT-12 significantly improved from 50.2 ± 18 to 86.5 ± 19 ( P < 0.0001), and pain score decreased from 5.6 ± 1.8 to 1.0 ± 1.5 ( P < 0.0001) on the Visual Analog Scale pain score. Regarding functional outcome and pain, 10 of the 11 patients and all patients reached the minimal clinically important difference (MCID), respectively. The postoperative average MOCART score was 87.2 (± 9.2). No adverse events or reoperations were observed. Conclusions Arthroscopic, autologous minced cartilage implantation for treating full-thickness acetabular cartilage lesions in FAIS shows statistically and clinically significant improvement at short-term follow-up.

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“…Two minutes was allowed to achieve primary cartilage and thrombin clot stability before an ACP-thrombin mixture was applied on top of the implanted tissue as described elsewhere. 15 …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minced Cartilage Implantation in Acetabular Cartilage Defects: Case Series with 2-Year Results

et al. 2023

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“…This innovative approach, described in recent studies by Zimmerer et al. [ 100 ] and Gebhardt et al. [ 101 ], involves arthroscopic preparation of the damaged cartilage, followed by mincing of autologous cartilage fragments using specialized instruments.…”

Section: Surgerymentioning

confidence: 99%

Therapie chondraler und osteochondraler Läsionen der Hüfte

Itha,

Vaishya,

Vaish

et al. 2023

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Chondral and osteochondral lesions encompass several acute or chronic defects of the articular cartilage and/or subchondral bone. These lesions can result from several different diseases and injuries, including osteochondritis dissecans, osteochondral defects, osteochondral fractures, subchondral bone osteonecrosis, and insufficiency fractures. As the cartilage has a low capacity for regeneration and self-repair, these lesions can progress to osteoarthritis. This study provides a comprehensive overview of the subject matter that it covers. PubMed, Scopus and Google Scholar were accessed using the following keywords: “chondral lesions/defects of the femoral head”, “chondral/cartilage lesions/defects of the acetabulum”, “chondral/cartilage lesions/defects of the hip”, “osteochondral lesions of the femoral head”, “osteochondral lesions of the acetabulum”, “osteochondral lesions of the hip”, “osteochondritis dissecans,” “early osteoarthritis of the hip,” and “early stage avascular necrosis”. Hip osteochondral injuries can cause significant damage to the articular surface and diminish the quality of life. It can be difficult to treat such injuries, especially in patients who are young and active. Several methods are used to treat chondral and osteochondral injuries of the hip, such as mesenchymal stem cells and cell-based treatment, surgical repair, and microfractures. Realignment of bony anatomy may also be necessary for optimal outcomes. Despite several treatments being successful, there is a lack of head-to-head comparisons and large sample size studies in the current literature. Additional research will be required to provide appropriate clinical recommendations for treating chondral/osteochondral injuries of the hip joint.

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