Treatment Options

Articular cartilage has a limited regeneration capacity. Untreated cartilage defects do not heal spontaneously, will increase and ultimately result in osteoarthritis. To prevent this destructive process, articular cartilage surgery aims to restore the structure and function of hyaline cartilage.

There are various treatment options for cartilage repair:

Non-surgical therapies:
  • Physical therapy
  • Oral or intra-articular medication
Surgical procedures:
  • Débridement, Cartilage shaving, Joint lavage
  • Microfracturing, Pridie Drilling, Abrasion
  • OATS (Osteo Articular Transfer System) /Mosaic Plasty
  • ACT/ACI (Autologous Chondrocyte Trans-/Implantation)
  • AMIC® Autologous Matrix Induced Chondrogenesis
  • Debridement, Cartilage shaving, Joint lavage

These procedures are mostly performed by arthroscopy in an outpatient setup. The damaged area is usually debrided, i.e. loose bodies and damaged or dead cells are removed, and the subchondral bone plate is smoothed. This often helps to relieve patient’s symptoms.

Microfracturing, Pridie Drilling, Abrasion

These methods which have been applied for more than twenty years stimulate the bone marrow. This stimulation allows slight bleeding into the cartilage defect site, thus utilizing the body's stem cell healing potential.

OATS (Osteo Articular Transfer System) /Mosaic Plasty

This surgical procedure using osteocartilige plugs from undamaged areas of the joint and transplanting them into a damaged area has been proven to be clinically useful, especially in smaller defects.

ACT/ACI (Autologous Chondrocyte Trans-/Implantation)

ACT is one of the first orthopedic biotechnologies that have been clinically available for more than fifteen years. The patient’s own chondrocytes are cultured in a laboratory and implanted with or without a scaffold into the defect area. The ACT treatment is suitable for patients with larger traumatic cartilage defects.

AMIC

AMIC® technique combines microfracturing with the application of a scaffold/matrix. This innovative biological technique for the treatment of cartilage damage uses the body’s own healing abilities in order to treat chondral and osteochondral lesions larger than 1-2 cm2. Through microfracturing, multipotent mesenchymal progenitor cells migrate from the subchondral bone into the defect. The resulting clot is stabilized by a matrix (e.g. Alpha Chondro Shield®) which fills and covers the defect site. Primarily, the natural and bioresorbable scaffold protects the underlying and adjacent tissue against mechanical loading and strains postoperatively. Furthermore, it stimulates the mesenchymal stem cells differentiation into chondrocytes and formation of hyaline-like cartilaginous repair tissue.

Treatment options are determined by:

  • Aetiology of the cartilage defect
  • Location of the defect
  • Defect size and classification
  • Costs

 

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