Aktueller Stand der Behandlungsm�glichkeiten von Knorpeldefekten

Abstract

Even centuries ago, before much was known about the cell biology of cartilage, it was clear that trauma and degenerative disease affecting cartilage were not easily amenable to treatment. As neither operative nor conservative methods have so far been able to initiate the regeneration of cartilage, the methods used have been aimed at reducing mechanical stress on the damaged tissue or stimulating the overgrowth of defects by fibrous tissue . These efforts have never resulted in the restoration of a normal joint surface. Based on recent successful research in cell biology, many studies have now documented considerable progress in the transplantation of chondrocytes grown in vitro. Another boost for the transplantation of joint cartilage together with bony tissue came with the development of new surgical instruments. In particular, the extremely high-precision methods used in production of the new diamond-coated cutting instruments has made it possible to apply a press-fit technique allowing really accurate defect coverage. Nonetheless, the literature does not contain any classification of the different techniques by indication; nor is any such classification reflected in clinical practice.