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Erschienen in: rheuma plus 3/2015

01.09.2015 | Orthopädie

Orthopädisch-chirurgische Therapie des Gelenkknorpeldefektes

verfasst von: Prof. Dr. Stefan Nehrer

Erschienen in: rheuma plus | Ausgabe 3/2015

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Zusammenfassung

Hintergrund

Die Tatsache, dass Gelenkknorpel nicht oder nur insuffizient heilt, ist altbekannt (Hunter, Philos Trans R Soc Lond 42b:514–521, 1743). Seit Jahrzehnten werden sehr aufwändige Versuche unternommen, die ungenügende Regenerationsfähigkeit von Knorpel zu verbessern. Operationsmethoden wie Bohrung und Abrasionsarthroplastik zur Behandlung von Knorpeldefekten können nur eine fibrokartilaginäre Vernarbung des Defektes erzielen, wobei der klinische Verlauf und die langfristige biomechanische Belastbarkeit dieses Narbengewebes unvorhersehbar bleiben.

Methoden

Osteochondrale Transplantationen mit Knochenzylindern sind technisch schwierig und mit limitierten Graftressourcen und Entnahmemorbidität behaftet. Allografts sind mit hohem logistischem Aufwand verbunden und bergen ein immunologisches und infektiöses Gefahrenpotenzial.

Ergebnisse

Die Implantation von kultivierten, autologen Chondrozyten bei akuten und chronischen Knorpeldefekten erzielte sowohl experimentell als auch in ersten klinischen Anwendungen eine verbesserte Regeneration von hyalinem Gelenkknorpel.

Schlussfolgerung

Die Einführung von Biomaterialien in der Knorpelzelltransplantation hat zur Entwicklung der Methoden des Tissue Engineering geführt, die sicher dazu beitragen, die Prognose bei der Behandlung von Knorpeldefekten noch weiter zu verbessern.
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Metadaten
Titel
Orthopädisch-chirurgische Therapie des Gelenkknorpeldefektes
verfasst von
Prof. Dr. Stefan Nehrer
Publikationsdatum
01.09.2015
Verlag
Springer Vienna
Erschienen in
rheuma plus / Ausgabe 3/2015
Print ISSN: 1868-260X
Elektronische ISSN: 2191-2610
DOI
https://doi.org/10.1007/s12688-015-0027-1

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