Modern operative therapy Cartilage surgery and artificial joints
Cartilage and cartilage cell transplants are among the most modern orthopedic procedures, in order to restore the function of joint surfaces.
By smaller cartilage damage, such as following osteochondrosis (the dieing off of cartilage-bone areas) or also as a result of injury-induced damage, techniques intended to restore the joint-cartilage surface are increasingly applied.
For instance:
- cartilage- or cartilage-bone transplants (e.g. Mosaicplasty, OATS)
- Transplantation of analogous cartilage cells by means of periosteum or polymer fleece
By the Mosaicplasty, or OATS method, cartilage-bone cylinder is removed from lesser-affected zones of the same (or another) joint with a small incision or through arthroscopy and transplanted to the defected point. By the Autologous Osteochondrondral transplantation (ACT) and similar techniques, cartilage cells as well as serum are removed with the help of a cartilage biopsy.
In this procedure, autologous cartilage cells are cultivated, then applied to the defect with a piece of periosteum or special base material. The techniques mentioned are only sensible, when the optimal preconditions apply. These include a straight leg axis, stable ligaments, and an intact meniscus. Before an operation, we determine whether optimal preconditions are present.
Classical surgical therapeutic measures
In the case of greater cartilage damage, the individually most effective operative procedure can be chosen from a wide palette of "classical" procedures.
- without joint replacement
- complete- or partial prostheses for superficial improvement
- currently rather seldom: joint-partner removal
- arthroscopy, e.g. femur-head or kneecap
"joint toilette"
- reinforcement of the joint. e.g. ankle
The further development of joint prostheses (endoprostheses) is subject to constant intense research. In recent years, a remarkable improvement in function and quality has been achieved. We choose together with out patients the most suitable prosthesis concerning model and method of implantation with the help of examination results. It is determined whether a cemented or non-cemented technology is best applied. Joint reinforcement is nowadays usually the method of last choice, however, in certain cases, particularly on the ankle, owing to its few restrictions, it can make good sense.
Indication
- by conservative non-treatable conditions of pain
- advanced joint degeneration, loss of cartilage (according to x-rays and magnetic resonance imaging)
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