Stellenwert und Technik der Autologen Chondrozyten-Transplantation

Fritz, J.; Gaissmaier, Christoph; Schewe, B.; Weise, K.

doi:10.1055/s-2005-836792

Cited by 18 publications

(16 citation statements)

References 14 publications

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“…Mehrere Biomaterialien natürlicher oder synthetischer Herkunft [24] befinden sich für diesen Zweck mittlerweile in der klinischen Evaluationsphase, und es wurden bereits die ersten ermutigenden Ergebnisse veröffentlicht [6,21,23,31,59,69].…”

Section: Periostlappenunclassified

Indikations- und Durchführungsempfehlungen der Arbeitsgemeinschaft „Geweberegeneration und Gewebeersatz” zur Autologen Chondrozyten-Transplantation (ACT)

Behrens¹,

Bösch²,

Bruns³

et al. 2004

Z Orthop Ihre Grenzgeb

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103

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For the treatment of full-thickness articular cartilage lesions of the knee joint, as a result of trauma or osteochondritis dissecans, a variety of biological reconstruction techniques have been developed. Different studies, some of which were performed as randomised, prospective clinical studies, showed that the autologous chondrocyte transplantation (ACT) provides the most satisfying and reliable method of cartilage reconstruction in the adult when applied to defects exceeding 4 cm (2). Based on these results, ACT seems to be of economic benefit, as the risk of developing osteoarthritis correlates significantly with the size of the cartilage defect, when not treated properly and in time. Surveying the studies on basic scientific aspects of ACT, cartilage defect animal models and clinical studies, it can be concluded that clinical results of ACT depend on a variety of factors. In this review, published by the joined advisory board of the German Societies of Traumatology (DGU) and Orthopaedic Surgery (DGOOC), we summarize the current knowledge available and the state of the art concerning ACT. Especially we discuss the advantages of different procedures, methods for treating knee cartilage defects and factors that influence the outcome of the different treatment regimens, with the aim to develop guidelines for the correct indication and application of the ACT.

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Section: Periostlappenunclassified

Indikations- und Durchführungsempfehlungen der Arbeitsgemeinschaft „Geweberegeneration und Gewebeersatz” zur Autologen Chondrozyten-Transplantation (ACT)

Behrens¹,

Bösch²,

Bruns³

et al. 2004

Z Orthop Ihre Grenzgeb

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103

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“…Grundsätzlich sollte bei Vorliegen eines Gelenkknorpelschadens eine zeitnahe Rekonstruktion angestrebt werden, da größere Knorpeldefekte in der Regel in eine Arthrose münden [1,6].…”

Section: Operative Therapieunclassified

“…Darüber hinaus ist eine Zulassung des Biomaterials für eine trägerge-koppelte ACT durch die zuständigen Stellen notwendige Voraussetzung für dessen klinischen Einsatz [1]. Ein weiterer Vorteil der matrixgekoppelten Technik liegt darin, dass sich im Vergleich zur konventionellen ACT die Zugangswege verkleinern und Schnitt-Naht-Zeiten wesentlich reduzieren lassen, wodurch sich eine geringere Komorbidität ergibt und der stationäre Aufenthalt verkürzt wird [2,6].…”

Section: Matrixassozierte Autologe Chondrozytentransplantationunclassified

Therapie von Gelenkknorpelschäden

Albrecht

Weise

2008

Chirurg

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Lesions of adult articular cartilage do not heal or regenerate. They give rise to the development of osteoarthritis, and surgical treatment is necessary before the initiation of joint degeneration. Various treatment modalities ranging from microfracture to autologous mosaicplasty and autologous chondrocyte transplantation are available. Commonly they are distinguished by the presence or absence of cell transplantation. The treatment choice depends on size, depth, and location of the lesion; therefore exact classification is mandatory. The surgical procedure aims to reconstruct a physiological distribution of the biomechanical forces by surface restoration. Additional joint pathologies such as mechanical axis deviation, meniscal defects, and ligament insufficiencies threaten the surgical success and must be addressed simultaneously.

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“…Cell sources may be autologous chondrocytes, periosteum or mesenchimal stem cells (Wakitani et al 2002;Fritz et al 2005). Recently Grogan et al identified specific markers of monolayerexpanded chondrocytes that allow selection of highly chondrogenic subpopulations (Grogan et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Methodological models for in vitro amplification and maintenance of human articular chondrocytes from elderly patients

et al. 2007

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Articular cartilage defects, an exceedingly common problem closely correlated with advancing age, is characterized by lack of spontaneous resolution because of the limited regenerative capacity of adult articular chondrocytes. Medical and surgical therapies yield unsatisfactory short-lasting results. Recently, cultured autologous chondrocytes have been proposed as a source to promote repair of deep cartilage defects. Despite encouraging preliminary results, this approach is not yet routinely applicable in clinical practice, but for young patients. One critical points is the isolation and ex vivo expansion of large enough number of differentiated articular chondrocytes. In general, human articular chondrocytes grown in monolayer cultures tend to undergo dedifferentiation. This reversible process produces morphological changes by which cells acquire fibroblast-like features, loosing typical functional characteristics, such as the ability to synthesize type II collagen. The aim of this study was to isolate human articular chondrocytes from elderly patients and to carefully characterize their morphological, proliferative, and differentiative features. Cells were morphologically analyzed by optic and transmission electron microscopy (TEM). Production of periodic acid-schiff (PAS)-positive cellular products and of type II collagen mRNA was monitored at different cellular passages. Typical chondrocytic characteristics were also studied in a suspension culture system with cells encapsulated in alginate-polylysine-alginate (APA) membranes. Results showed that human articular chondrocytes can be expanded in monolayers for several passages, and then microencapsulated, retaining their morphological and functional characteristics. The results obtained could contribute to optimize expansion and redifferentiation sequences for applying cartilage tissue engineering in the elderly patients.

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Stellenwert und Technik der Autologen Chondrozyten-Transplantation

Cited by 18 publications

References 14 publications

Indikations- und Durchführungsempfehlungen der Arbeitsgemeinschaft „Geweberegeneration und Gewebeersatz” zur Autologen Chondrozyten-Transplantation (ACT)

Indikations- und Durchführungsempfehlungen der Arbeitsgemeinschaft „Geweberegeneration und Gewebeersatz” zur Autologen Chondrozyten-Transplantation (ACT)

Therapie von Gelenkknorpelschäden

Methodological models for in vitro amplification and maintenance of human articular chondrocytes from elderly patients

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