Knorpelregeneration mittels zellfreier Kollagen-Typ-I-Matrix – Vergangenheit, Gegenwart und Zukunft (Teil 1 – klinische Aspekte)

Zusammenfassung

Die Knorpelregeneration mit zellfreien Matrices hat sich vor mittlerweile über 10 Jahren aus der matrixassoziierten autologen Knorpelzelltransplantation (MACT) entwickelt. Anpassungen der rechtlichen Rahmenbedingungen und höhere Hürden für die Zelltherapie haben dazu geführt, dass sich die Verfahren als eigenständige Alternative zur MACT etabliert haben. Die als matrixinduzierte autologe Knorpelregeneration (MACR) einzuordnenden Verfahren setzen sämtlich auf den chemotaktischen Reiz einer vernetzten Matrix, die zumeist aus Kollagenen besteht. Am Beispiel eines marktüblichen Kollagen-Typ-I-Hydrogels soll der Stand der klinischen Erfahrungen mit der MACR zusammengefasst und ein Ausblick auf die Entwicklung des Verfahrens ermöglicht werden. Es konnte in den hier zusammengefassten klinischen Fallserien über die vergangenen Jahre gezeigt werden, dass die Anwendung der Matrix nicht nur sicher ist, sondern sowohl für kleine (~ 10 mm) als auch große (> 10 mm) fokale Knorpelschäden gute klinisch-funktionelle und MR-tomografische Ergebnisse liefert. Somit nimmt die MACR mittels Kollagen-Typ-I-Matrix, je nach Defektgrößte, sowohl in der direkten Konkurrenz zur Mikrofrakturierung als auch zur MACT eine wichtige Stellung als Alternativverfahren ein.

Schlüsselwörter

Knorpel - Matrix - zellfrei - Kollagen - klinische Studie

Publication History

Article published online:
03 August 2020

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