Cartilage replacement in damaged knee joints

Cartilage replacement in damaged knee joints


The University Medical Center Manheim leads the field in cartilage replacement treatment for damaged knee joints. It is in no way a cure or remedy for everyone
who suffers from knee pain, but it offers a marked improvement above all for young people if premature total knee replacement can be avoided. Cartilage replacement treatment is above all used for knee joints which have been damaged by a fresh injury. Some young people such as this 19-year-old patient suffer from an illness which causes damage to the cartilage which functions as a
shock absorber between the bones. Professor Hanns-Peter Scharf,
director of the orthopedic and traumatic surgical center, has driven forward the development of this new procedure at the University Medical Center Manheim. This is actually a complex process: In the first operation, a small amount of cartilage tissue is extracted. At this point, the number of cartilage cells is very small. Therefore, they must be cultured and reproduced in a further process outside the body. Ater they have been multiplied, they are
reimplanted into the body, so that the cells are once again located in a normal environment and produce cartilage tissue. This is why this is referred to
as cartilage cell transplantation. One advantage of this procedure is, among others, that there is no danger of the patient rejecting the tissue as can be the case in other transplantations,
since the procedure uses the patient’s own cells. The key advancement, which the University Medical Center has also been involved in developing,
lies in the surgical technique. In the past, cartilage cells were inserted into the knee joint in the form of up so to say liquid soup, so it was not surprising that the majority of
the cells dispersed. Today, these cells are inserted in the form of a matrix, i.e. a tissue sample which holds them in place. This has significantly contributed to an improvement in outcomes. First of all, the surgical team has exposed the knee joint and then cleaned and adjusted the wound so that the implant can be placed. Before this, the surgeon takes measurements of the area where the newly grown cartilage is to be transplanted. Then the cell disc is cut to measure.
The implant is very carefully inserted. Surprisingly enough, this platelet which is to replace the generally one millimeter thick cartilage is really very thin. However, during the healing process, a sufficiently thick layer of cartilage is regenerated in the knee joint. You have to imagine it like this:
The cells are actually not the tissue. The cells create the substances that take over the mechanical functionality of the articular surface. These substances can be regenerated from the cells in the joint so that the articular surface is reconnected. All research so far shows that a very close similarity to the original cartilage can be achieved. We’ll have to wait and see what progress has been made in 20 or 30 years time. The 19 year old patient’s implant is carefully stitched into position so that it does not fail to have the desired effect in the right place. The procedure is so new that no long-term experience could yet be gathered. But the success rate so far is remarkable. If you review the clinical results and look at
how patients feel after this type of operation you’ll generally see a very rapid and sustained improvement. That means: pain is reduced and functionality is restored. The University Medical Center Mannheim began
to study this procedure at a very early stage and therefore leads the field in southern Germany. This means that many patients travel from far away to undergo this operation. We were already working experimentally with this at a time when the procedure was not reimbursed by insurance companies. We participated in the first clinical studies in south Germany . This means that it has a long history for us. Since we found this topic so exciting: This is true regenerative restorative medical technology!

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