The incidence of damage caused to knee and ankle joints, by accidents, sporting injuries and strains, has increased continuously in recent years. The fact that defective cartilage cannot regenerate itself, in adults in particular, represents a major problem in this respect, meaning that operative reconstructive intervention is often called for to delay and avoid arthrosis or the implantation of artificial joints. In Germany alone, the number of people suffering from arthrosis is estimated to be several million. Worldwide, too, the number of implants of artificial knee joints is rising constantly. One key reason for this is non- or insufficiently treated cartilage damage lead to further arthrosis of the knee joint.
First presented in 1994, autologous cartilage cell transplanting – or ACT – is the first procedure through which full-layer defects in joint cartilage can be permanently re-covered with hyaline-like cartilage, using the body’s own cells.
Existing methods for treating cartilage defects:
Detached fragments of bone cartilage are re-fixed in fresh injuries.
2. Tissue-response procedure (microfracturing):
With smaller defects, the cartilage is reconstructed following microfracturing of the bone lamella using precursor cells from the spinal cord. In most cases, however, this results in a biomechanically inferior scar tissue, often referred to as “fibrous cartilage”. In larger defects in particular, this regenerated tissue fails relatively quickly, and clinical results tend to be disappointing. On smaller defects and in younger patients, on the other hand, this method can be used successfully in many cases.
3. Osteocondral transplantation (OCT):
Transplantation of the body’s own cartilage bone plugs from less stressed areas of the joint to the defect. The end result of this is “mixed cartilage”, as fibrous cartilage develops in the spaces between the individual hyaline cylinders. The need to take cartilage-bone punches from less stressed, unscathed areas means that this method is limited to use in treating smaller defects. If too much donor cylinder is taken to cover the defect, cartilage defects at the extraction site can lead to painful arthrosis. Such cases are referred to as “donor site morbidity”.
Unlike these methods, ACT delivers extremely good results on larger traumatic defects of up to 14 cm2. The use of NOVOCART®3D allows for gentle reconstruction in a short OP time with overwhelmingly positive clinical results.
ACT cannot yet be used to treat generalized arthroses. Intensive work is currently being conducted in research, however, to enable even such degenerative joint diseases to be therapeutically treated using tissue-engineered products.
With NOVOCART®3D, the foundation stones for this have already been laid.
However, ACT remains a complex procedure, not least due to the complicated process of cell cultivation. To ensure successful application of NOVOCART® products, we train the treating physician extensively in theory and practice and provide assistance in the correct indication and cartilage extraction, through the use of a specially developed set of instruments, as well as support in transplantation and follow-up treatment.