Joint Surgeons in Germany

Gelenk Klinik Orthopaedic Clinic

Street:
Alte Bundesstrasse 58

Town:
D-79194 Gundelfingen

Germany

fon: +49-761-55 77 58 28

fax: +49-761-58 974 650

clinic@joint-surgeon.com

Cartilage Transplant

Autologous Cartilage Transplantation (ACT) -stopping osteoarthritis of the knee

Is irreversible cartilage damage still a fact of life?

Arthroscopic image of a 45 year old patient, with clearly visible damage to the cartilage surface of a knee-joint. The surface is no longer smooth and strong, but rough and vulnerable as a result of damage. Arthroscopic image of a 45 year old patient, with clearly visible damage to the cartilage surface of a knee-joint. The surface is no longer smooth and strong, but rough and vulnerable as a result of damage. © joint-surgeon.com

Cartilage cells are vital as cushions inside the joints of the body. Healthy cartilage tissue keeps joints smooth, flexible and pain free. If the cartilage tissue becomes damaged, this damage tends to be permanent. Joints become painful and lose their flexibility. Cartilage cannot regenerate naturally inside the body.

After some time the bones start to collide. The joints start to become inflamed and permanently stiff, unless a prosthetic joint is implanted. This painful process represents the irreversible development of osteoarthritis.

Which patients are suitable for knee cartilage cell transplantation?

Criteria for a viable patient for ACT
  • Articular defect 2.5 - 10 cm² size
  • Intact meniscus
  • Physiological axis - no misalignment
  • Free range of motion
  • Intact ligaments in knee

Cartilage transplantation is not advisable for all patients. Ideally patients are between 15 and 55 years of age, although this is flexible.

If fitness and the general level of health is good, active people up to the age of 65 years have successfully received cartilage transplants and have gone on to enjoy sports such as skiing once more.

The following factors are more likely to be a barrier to successful transplants than the age of the patient:

 

  • The patient is overweight (excess weight puts strain on joints)
    Solution: presurgery weight control.
  • Malalignment of the bones in the leg eg. bow leggedness.
    Solution: malalignment can be addressed by osteotomy during the same surgical appointment as cartilage transplant.
  • Joint surfaces opposite the area of damaged cartilage are also rough (often as a result of trauma), in this case a metal implant (Repicci inlay) has to be fitted.
  • There is a genetically determined weakness in the cartilage tissue.
    Solution: partial or full prosthesis.
  • Instability of the knee due to damaged ligaments.
    Solution: ligaments must be reconstructed e.g. by ACL reconstruction
  • Instability of the knee due to missing or severely damaged meniscus.
    Solution: A Repicci inlay might be preferable.
  • The area of the cartilage defect is too large (greater than 10 cm).
    Solution: the surgeon may recommend a joint preserving Repicci inlay.
  • Due to another medical condition or very old age a quick recovery (weight bearing) time is important.
    Solution: in this case a Repicci inlay might be more suitable due to the possibility of full weight bearing on the day after surgery.

Rehabilitation after Cartilage Transplant: What happens after surgery?

Directly after transplantation the cartilage cells are a soft jelly like substance. They will not have the thickness and resilience of the surrounding cartilage. This is comparable to a newly sown lawn. Just as new grass must be protected from heavy use eg. football being played on it, the newly implanted cartilage must be protected from full weight bearing activity. On the third day following the operation the patient may leave the hospital. As standing or walking unaided is not possible for the next six weeks, the patient must use crutches and later on a walking stick.

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Orthopaedic Clinic Germany

orthopedic clinic and surgeon in Germany

Gelenk Klinik Orthopaedic
Clinic

ISO 9001:2008 certified quality

Street:
Alte Bundesstrasse 58

Town:
D-79194 Gundelfingen

Germany

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Location of Gelenk-Klinik Gundelfingen
View Details of the location
  • Distance to EURO-Airport Basel: 80 km (45 mins)
  • Distance to Zurich: 161 km (1h 40)
  • Distance to Frankfurt: 259 km (2h 20)

Centre for Arthroplasty

Center of Excellence in Arthroplasty

Certified Centre for Arthroplasty (Centre for Endoprosthesis)