Veterinary Wound Healing Association 5th Congress, Hannover, Germany. May 10-12 2001
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| AUTOLOGOUS CHONDROCYTE TRANSPLANTATION (ACT): A NEW TREATMENT MODALITY FOR DEEP CARTILAGE DEFECTS IN THE KNEE Martijn van Griensven, M.D. Ph.D. Department of Trauma Surgery Hannover Medical School Carl-Neuberg-Straße 1 D-30625 Hannover Germany Tel: +49-511-5322927 Fax: +49-511-5325877 E-mail: Griensven.Martijn.van@MH-Hannover.DE Full thickness defects of articular cartilage in the knee have a poor capacity for repair. They may progress to severe osteoarthritis disrupting both cartilage and subchondral bone. The regeneration potential of cartilage is poor and leads to mechanical inferior fibrous tissue. The present therapeutical procedures may minimally delay the occurrence of complications, but cannot prevent them. The usual treatment of such lesions is the substitution of the knee joint with an artificial prosthesis. In 1994, a new biological based technique was introduced to treat such cartilage defects: autologous chondrocyte transplantation (ACT). Cartilage slices (300 to 500 mg) were obtained by means of an arthroscopy from a minor load-bearing area on the upper medial femoral condyle of the damaged knee. Cells were isolated from this healthy cartilage and expanded (10-fold) for 21 days using cell culture methods. In a second operation, the chondral lesion was excised as far as the normal surrounding cartilage, but not as far as the subchondral bone. The defect was covered with a periosteal flap and the cultured chondrocytes were injected beneath. Excellent to good outcomes were achieved in 90% of ACT-treated femorocondylar defects after 10 years. The treatment of patellar defects only resulted in 69% in an excellent to good outcome. ACT induces a considerable improvement of the quality of the cartilage regeneration (hyaline-like cartilage containing collagen type II). Therefore, this technique seems to pose a feasible and practicable alternative for the treatment of severe (osteo?)chondral lesions in the femorotibial joint by forming hyaline-like cartilage. Return to index of Abstracts | About the VWHA |