Nachbehandlung bei der autologen Chondrozytentransplantation

Pietschmann, Matthias F.; Horng, Annie; Gläser, Christian; Albrecht, Dirk; Bruns, J.; Scheffler, Sven; Marlovits, S.; Angele, Peter; Aurich, Matthias; Bösch, U.; Fritz, Jürgen; Frosch, Karl‐Heinz; Kolombe, Thomas; Richter, Wiltrud; Petersen, Jan; Nöth, Ulrich; Niemeyer, Philipp; Jagodzinsky, M.; Kasten, Philip; Ruhnau, Klaus; Müller, Peter E.

doi:10.1007/s00113-012-2293-x

Cited by 10 publications

(2 citation statements)

References 19 publications

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“…After knee retropatellar surgery, patients are instructed to engage in full extension, undertake continuous passive motion (CPM) for 3–8 h per day starting 24 h post-surgery for 6 weeks, maintain touch-down contact for 6 weeks with gradual weight increases of 15–20 kg per week, initiate sports such as swimming and biking (without resistance) after 6 weeks, and incorporate low-impact activities for 3 months while gradually reintroducing high-impact activities over a period exceeding 12 months. Knee femoral surgeries involve no restrictions on the range of motion (ROM) and follow a rehabilitation protocol similar to knee retropatellar procedures [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

A New Approach to Postoperative Rehabilitation following Mosaicplasty and Bone Marrow Aspiration Concentrate (BMAC) Augmentation

Gherghel,

Onu,

Iordan

et al. 2024

Biomedicines

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Background: Chondral defects in the knee present a significant challenge due to their limited self-healing capacity, often leading to joint degeneration and functional disability. Current treatments, including surgical approaches like mosaicplasty and regenerative therapies such as bone marrow aspirate concentrate (BMAC) augmentation, aim to address these defects and improve patient outcomes. Materials and Methods: This study conducted a single-center, randomized controlled trial to evaluate the efficacy of different treatment approaches and rehabilitation protocols for chondral defects. Thirty-seven subjects presenting with symptomatic chondral or osteochondral defects (>3 cm2) in the weight-bearing region of the femoral condyle were partitioned into three groups, and underwent mosaicplasty with or without BMAC augmentation, followed by either a 6-week or 12-week rehabilitation program. Group 1 (n = 10) received mosaicplasty combined with BMAC augmentation and engaged in a twelve-week two-phase rehabilitation protocol. Group 2 (n = 15) underwent mosaicplasty alone and participated in the same twelve-week two-phase rehabilitation regimen. Meanwhile, Group 3 (n = 12) underwent mosaicplasty and underwent a shorter six-week one-phase rehabilitation program. Clinical assessments were performed using the visual analog scale (VAS) for pain, goniometry for the knee’s range of motion (ROM), manual muscle testing (MMT) for quadricep strength, and the Western Ontario and McMaster University Arthritis Index (WOMAC) for functional evaluation in three test phases. Results: Significant differences in WOMAC scale scores were observed between the three groups at the intermediate (F(2, 34) = 5.24, p < 0.010) and final (F(2, 34) = 111, p < 0.000) stages, with post hoc Tukey tests revealing variations shared among all three groups. The between-group analysis of the VAS scale demonstrated no statistically significant difference initially (F(2, 34) = 0.18, p < 0.982), but significant differences emerged following the intermediate (F(2, 34) = 11.40, p < 0.000) and final assessments (F(2, 34) = 59.87, p < 0.000), with post hoc Tukey tests revealing specific group variations, notably between Group 1 and both Group 2 and Group 3, and also between Group 3 and Group 2. The between-group analysis of quadricep muscle strength using MMT scores revealed no statistically significant differences initially (F(2, 34) = 0.376, p < 0.689) or following the intermediate assessment (F(2, 34) = 2.090, p < 0.139). The one-way ANOVA analysis showed no significant difference in the knee ROM initially (F(2, 34) = 1.037, p < 0.366), but significant differences emerged following intermediate (F(2, 34) = 9.38, p < 0.001) and final assessments (F(2, 34) = 11.60, p < 0.000). Post hoc Tukey tests revealed significant differences between Groups 1 and 2, Groups 1 and 3, and Groups 2 and 3 at intermediate and final assessments. Conclusions: The patients who received BMAC augmentation and completed a 12-week rehabilitation protocol had significantly better outcomes in pain relief, knee function, and ROM when compared to those who did not receive BMAC augmentation or those who completed a shorter rehabilitation period. Our findings suggest that combining mosaicplasty with BMAC augmentation and a comprehensive rehabilitation program can lead to superior clinical outcomes for patients with chondral defects in the knee.

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Section: Introductionmentioning

confidence: 99%

A New Approach to Postoperative Rehabilitation following Mosaicplasty and Bone Marrow Aspiration Concentrate (BMAC) Augmentation

Gherghel,

Onu,

Iordan

et al. 2024

Biomedicines

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“…Furthermore, these do include the traditional techniques of microfracture, chondrocyte transplantation and osteochondral transplantation; not considering more novel techniques available in the market. Opposing the emergence of novelty, one is in danger to neglect basic techniques (Gomoll and Minas 2014 ; Hindle et al 2014 ; Pietschmann et al 2014 ) of cartilage repair which include patient selection, addressing co-pathologies, rehabilitation and foremost elementary surgical techniques. Such basics have to be considered equally important in order to realise optimal treatment outcome for the benefit of the patient.…”

Section: Introductionmentioning

confidence: 99%

Practical execution of defect preparation prior to surgical cartilage intervention: results from a representative meeting survey among experts

et al. 2015

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During a specialised orthopedic meeting held on ‘the state of the art in cartilage defect repair’, all previously fully-registered participants were requested to participate in an electronic survey by the use of a moderator-presented “Power Point Presentation-based” 9-item questionnaire. The aim of this survey was to assess indication, approach, and treatment execution of cartilage defect debridement prior to planned microfracture (MFX) or autologous chondrocyte implantation (ACI). All participants completed the questionnaire (n = 146) resulting in a return rate of 100 %. An uncertainty exists as to whether the removal of the calcifying layer prior to cartilage repair must be carried out or not. The same was true for the acceptability of subchondral bleeding prior to microfracturing and its handling prior to autologous chondrocyte implantation. There is a degree of unanimity among experts regarding the management of osteophytes and bone marrow edema. In a homogenous society collective of consultants that frequently deal with cartilage defective pathologies, there still remain a significant heterogeneity in selected topics of defect debridement.

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Juvenile Osteochondrosis dissecans am Knie

Krause¹,

Korthaus²,

Meenen³

2020

Orthopädie Und Unfallchirurgie

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Nachbehandlung bei der autologen Chondrozytentransplantation

Abstract: This manuscript summarizes the recommendations of the members of the German clinical tissue regeneration study group on postsurgical rehabilitation and MRI assessment after ACI (level IVb/EBM).

Cited by 10 publications

References 19 publications

A New Approach to Postoperative Rehabilitation following Mosaicplasty and Bone Marrow Aspiration Concentrate (BMAC) Augmentation

A New Approach to Postoperative Rehabilitation following Mosaicplasty and Bone Marrow Aspiration Concentrate (BMAC) Augmentation

Practical execution of defect preparation prior to surgical cartilage intervention: results from a representative meeting survey among experts

Juvenile Osteochondrosis dissecans am Knie

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