Über die Einheilung replantierter chondraler Fragmente

Abstract

Basing on encouraging results with the fixation of pure articular cartilage with the fibrin sealant in animal experiments, pure cartilage fragments were replanted in human patients using fibrin sealant. From individual cases biopsies could be taken from macroscopically not well healed areas during arthroscopic examination. The histological results from these cases are presented together with overall clinical experiences. Six weeks after operation one side of the graft showed no union with the subchondral bone and was also separated from the cartilage bed. However, after three and six months, the grafted cartilage had fused with subchondral bone, but pannus-like tissue was covering the surface and filling the cleft at the border to the bed. After one and five years, complete fusion with the subchondral bone and the surrounding cartilage can be demonstrated. There is always covering pannus at the larger observation times. In the majority of the 48 cases treated so far excellent clinical results were obtained, enabling the patients to take up their sporting activities again.

Fixation of osteochondral fragments in the human knee using Meniscus Arrows®

“…The chondral part of the fragment in our three patients with osteochondral fractures was fixed with Tissuecoll ® , according to recommendations in the literature [6, 18] to promote healing. Good and stable congruency was found during control arthroscopy of the cartilage edges.…”

Present and Future Therapies of Articular Cartilage Defects

“…It has to be mentioned that grafting of pure articular cartilage alone is of no success, nor is the replantation of isolated cartilage flakes after traumatic dissociation, ablation without a bony support, as cartilage does not heal to bony surfaces nor bone manages cartilage fixation. Only experimental and clinical data from one group suggest some success with fibrin-glue fixation [55][56][57]. Consequently, cartilage is usually transplanted with the underlying bone plate (= osteochondral grafts).…”