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AGA2012-258
2 Jahres-Ergebnisse nach einzeitiger Operation zum Knorpelaufbau mit einer zellfreien
Polyglycolsäure-Hyaluronanbasierten Matrix
2 year follow-up after one-stage cartilage repair with a polyglycolic acid-hyaluronan scaffold:
Histological, clinical and functional results
Authors
* Sven Behrendt Ev. KH Lütgendortmund Unfallchirurgie, Dortmund, Germany
Abstract
Fragstellung: Introduction: Microfracture is a first-line treatment option for cartilage repair. Advanced techniques
combine bone-marrow stimulation with the benefits of scaffold materials. In this work, the histological and clinical
outcome at up to 2 year follow-up is presented for one-step cartilage repair using a cartilage implant made of
polyglycolic acid and incorporated hyaluronic acid.
Methodik: Material and methods: In an arthroscopic approach, 10 patients with knee condyle defects were
treated with microfracture and additional defect covering with a cartilage implant made of polyglycolic acid and
incorporated hyaluronic acid (chondrotissue®). At a follow-up of up to 2 years, the clinical outcome was assessed
by second-look arthroscopy, histological evaluation of chondrocytic marker proteins, MRI examination and
functional scores. Additionally, the impact of difficult biomechanical conditions like extension deficits, impact
loading problems due to malalignment or meniscus resection was evaluated on the clinical outcome.
Ergebnis: Results: At a follow-up of up to 2 years, the newly formed repair tissue showed hyaline cartilage
markers like collagen type II, proteoglycans and S100 protein. Clinical outcome revealed a good defect filling and
integration into the defect as evaluated by MRI and second-look arthroscopy and a functional improvement of
patients´ situation. In cases with difficult biomechanical conditions like malalignment, meniscus resection or
extension deficit an increased load bearing was shown to result in limited repair tissue formation and therefore
have to be treated concomitant or prior to cartilage repair.
Schlussfolgerung: Conclusion: We conclude that the chondrotissue® technique is a safe and promising
cartilage repair option with good clinical, histological and functional outcome. Patients with biomechanical
malconditions have to be treated within or prior cartilage repair to achieve sufficient repair tissue formation.
Keywords
one stage cartilage repair, pga-hyaluronan scaffold
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Vortrag
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