Download PDF
Z Orthop Unfall 2012; 150(4): e121-e142
DOI: 10.1055/s-0032-1315242
Refresher Orthopädie und Unfallchirurgie
Georg Thieme Verlag KG Stuttgart · New York

Knorpelregeneration

M. O. Brix
1   Universitätsklinik für Orthopädie, Medizinsche Universität Wien, Wien
,
C. Chiari
1   Universitätsklinik für Orthopädie, Medizinsche Universität Wien, Wien
› Author Affiliations
Further Information

Publication History

Publication Date:
27 August 2012 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die Behandlung von Schäden des Gelenkknorpels stellt große Anforderungen an die Medizin. Für den Patienten bedeutet ein Knorpelschaden Schmerzen, Funktionseinschränkung und eine verminderte Lebensqualität, aber auch ein erhöhtes Risiko für einen frühzeitigen Gelenkersatz. Heute gibt es eine Vielzahl an Therapiemöglichkeiten, die eine Verbesserung der Situation für den Patienten erlauben. Mosaikplastik, knochenmarkstimulierende und zellbasierte Verfahren stehen seit Jahren in klinischer Anwendung. In diesem Artikel werden die Klassifikation und Abklärung von Knorpelschäden sowie verschiedene Knorpelreparaturverfahren und deren Indikationen dargestellt.

Abstract

Articular cartilage damage is challenging to treat. The patient has to deal with pain, functional impairment and compromized quality of life. Ultimately, he has to face the risk of early total joint replacement. A variety of treatment options is available to improve the situation for the patient. Mosaicplasty, bone marrow-stimulating techniques and cell-based methods have been in clinical use for years. This article explains preoperative diagnosis and classification systems of cartilage lesions and presents different cartilage repair procedures and their indications.

Key words

Knorpel - Knorpelregeneration - Knie - Knorpelzelltransplantation - Mikrofrakturierung

Key words

cartilage - cartilage repair - knee - chondrocyte transplantation - microfracturing

Literaturverzeichnis als PDF

 

  • Literatur

  • 1 Buckwalter JA, Mankin HJ. Articular cartilage: degeneration and osteoarthritis repair regeneration and transplantation. Instr Course Lect 1998; 47: 487-504
    PubMedGoogle Scholar
  • 2 Buckwalter JA, Mankin HJ. Articular cartilage: tissue design and chondrocyte-matrix interactions. Instr Course Lect 1998; 47: 477-486
    PubMedGoogle Scholar
  • 3 Steinhagen J, Niggemeyer O, Bruns J. [Etiology and pathogenesis of osteochondrosis dissecans tali]. Orthopäde 2001; 30: 20-27
    PubMedGoogle Scholar
  • 4 Johnson DL, Urban WP, Caborn DN et al. Articular cartilage changes seen with magnetic resonance imaging-detected bone bruises associated with acute anterior cruciate ligament rupture. Am J Sports Med 1998; 26: 409-414
    PubMedGoogle Scholar
  • 5 Peterson L, Minas T, Brittberg M et al. Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg [Am] 2003; 85 (Suppl. 02) 17-24
    CrossrefPubMedGoogle Scholar
  • 6 Recht M, Bobic V, Burstein D et al. Magnetic resonance imaging of articular cartilage. Clin Orthop Relat Res 2001; 391 (Suppl.) S379-S396
    CrossrefPubMedGoogle Scholar
  • 7 Disler DG. Fat-suppressed three-dimensional spoiled gradient-recalled MR imaging: assessment of articular and physeal hyaline cartilage. AJR Am J Roentgenol 1997; 1117-1123
    PubMedGoogle Scholar
  • 8 Kawahara Y, Uetani M, Nakahara N et al. Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee. Correlation of MR and arthroscopic findings. Acta Radiol 1998; 39: 120-125
    PubMedGoogle Scholar
  • 9 Trattnig S, Mlynárik V, Huber M et al. Magnetic resonance imaging of articular cartilage and evaluation of cartilage disease. Invest Radiol 2000; 35: 595-601
    CrossrefPubMedGoogle Scholar
  • 10 Yulish BS, Montanez J, Goodfellow DB et al. Chondromalacia patellae: assessment with MR imaging. Radiology 1987; 164: 763-766
    PubMedGoogle Scholar
  • 11 Marlovits S, Striessnig G, Resinger CT et al. Definition of pertinent parameters for the evaluation of articular cartilage repair tissue with high-resolution magnetic resonance imaging. Eur J Radiol 2004; 52: 310-319
    CrossrefPubMedGoogle Scholar
  • 12 Marlovits S, Singer P, Zeller P et al. Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: determination of interobserver variability and correlation to clinical outcome after 2 years. Eur J Radiol 2006; 57: 16-23
    CrossrefPubMedGoogle Scholar
  • 13 Bashir A, Gray ML, Boutin RD et al. Glycosaminoglycan in articular cartilage: in vivo assessment with delayed Gd(DTPA)(2-)-enhanced MR imaging. Radiology 1997; 205: 551-558
    CrossrefPubMedGoogle Scholar
  • 14 Gillis A, Bashir A, McKeon B et al. Magnetic resonance imaging of relative glycosaminoglycan distribution in patients with autologous chondrocyte transplants. Invest Radiol 2001; 36: 743-748
    CrossrefPubMedGoogle Scholar
  • 15 Williams A, Sharma L, McKenzie CA et al. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in knee osteoarthritis: findings at different radiographic stages of disease and relationship to malalignment. Arthritis Rheum 2005; 52: 3528-3535
    CrossrefPubMedGoogle Scholar
  • 16 Williams A, Gillis A, McKenzie C et al. Glycosaminoglycan distribution in cartilage as determined by delayed gadolinium-enhanced MRI of cartilage (dGEMRIC): potential clinical applications. AJR Am J Roentgenol 2004; 182: 167-172
    CrossrefPubMedGoogle Scholar
  • 17 Domayer SE, Welsch GH, Dorotka R et al. MRI monitoring of cartilage repair in the knee: a review. Semin Musculoskelet Radiol 2008; 12: 302-317
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Domayer SE, Welsch GH, Nehrer S et al. T2 mapping and dGEMRIC after autologous chondrocyte implantation with a fibrin-based scaffold in the knee: preliminary results. Eur J Radiol 2010; 73: 636-642
    CrossrefPubMedGoogle Scholar
  • 19 Burstein D, Velyvis J, Scott KT et al. Protocol issues for delayed Gd(DTPA)(2-)-enhanced MRI (dGEMRIC) for clinical evaluation of articular cartilage. Magn Reson Med 2001; 45: 36-41
    CrossrefPubMedGoogle Scholar
  • 20 Trattnig S, Burstein D, Szomolanyi P et al. T1 (Gd) gives comparable information as Delta T1 relaxation rate in dGEMRIC evaluation of cartilage repair tissue. Invest Radiol 2009; 44: 598-602
    CrossrefPubMedGoogle Scholar
  • 21 Marckmann P, Skov L, Rossen K et al. Nephrogenic systemic fibrosis: suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging. J Am Soc Nephrol 2006; 17: 2359-2362
    CrossrefPubMedGoogle Scholar
  • 22 Grobner T. Gadolinium – a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis?. Nephrol Dial Transplant 2006; 21: 1104-1108
    PubMedGoogle Scholar
  • 23 Thomsen HS. Nephrogenic systemic fibrosis: A serious late adverse reaction to gadodiamide. Eur Radiol 2006; 16: 2619-2621
    CrossrefPubMedGoogle Scholar
  • 24 Mosher TJ, Dardzinski BJ. Cartilage MRI T2 relaxation time mapping: overview and applications. Semin Musculoskelet Radiol 2004; 8: 355-368
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Smith HE, Mosher TJ, Dardzinski BJ et al. Spatial variation in cartilage T2 of the knee. J Magn Reson Imaging 2001; 14: 50-55
    CrossrefPubMedGoogle Scholar
  • 26 Mosher TJ, Liu Y, Yang QX et al. Age dependency of cartilage magnetic resonance imaging T2 relaxation times in asymptomatic women. Arthritis Rheum 2004; 50: 2820-2828
    CrossrefPubMedGoogle Scholar
  • 27 Mosher TJ, Smith HE, Collins C et al. Change in knee cartilage T2 at MR imaging after running: a feasibility study. Radiology 2005; 234: 245-249
    CrossrefPubMedGoogle Scholar
  • 28 Trattnig S, Mamisch TC, Welsch GH et al. Quantitative T2 mapping of matrix-associated autologous chondrocyte transplantation at 3 Tesla: an in vivo cross-sectional study. Invest Radiol 2007; 42: 442-448
    CrossrefPubMedGoogle Scholar
  • 29 Ling W, Regatte RR, Navon G et al. Assessment of glycosaminoglycan concentration in vivo by chemical exchange-dependent saturation transfer (gagCEST). Proc Natl Acad Sci USA 2008; 105: 2266-2270
    CrossrefPubMedGoogle Scholar
  • 30 Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br 1961; 43: 752-757
    PubMedGoogle Scholar
  • 31 Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am 2003; 85 (Suppl. 02) 58-69
    PubMedGoogle Scholar
  • 32 Bekkers JEJ, Inklaar M, Saris DBF. Treatment selection in articular cartilage lesions of the knee: a systematic review. Am J Sports Med 2009; 37 (Suppl. 01) 148S-155S
    Google Scholar
  • 33 de Windt TS, Bekkers JEJ, Creemers LB et al. Patient profiling in cartilage regeneration: prognostic factors determining success of treatment for cartilage defects. Am J Sports Med 2009; 37 (Suppl. 01) 58S-62S
    CrossrefPubMedGoogle Scholar
  • 34 Harris JD, Brophy RH, Siston RA et al. Treatment of chondral defects in the athleteʼs knee. Arthroscopy 2010; 26: 841-852
    CrossrefPubMedGoogle Scholar
  • 35 Krishnan SP, Skinner JA, Bartlett W et al. Who is the ideal candidate for autologous chondrocyte implantation?. J Bone Joint Surg Br 2006; 88: 61-64
    CrossrefPubMedGoogle Scholar
  • 36 Saris DBF, Vanlauwe J, Victor J et al. TIG/ACT/01/2000&EXT Study Group. Treatment of symptomatic cartilage defects of the knee: characterized chondrocyte implantation results in better clinical outcome at 36 months in a randomized trial compared to microfracture. Am J Sports Med 2009; 37 (Suppl.) 10S-19S
    CrossrefPubMedGoogle Scholar
  • 37 Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 1979; 10: 585-608
    PubMedGoogle Scholar
  • 38 Mina C, Garrett WE, Pietrobon R et al. High tibial osteotomy for unloading osteochondral defects in the medial compartment of the knee. Am J Sports Med 2008; 36: 949-955
    CrossrefPubMedGoogle Scholar
  • 39 Kanamiya T, Naito M, Hara M et al. The influences of biomechanical factors on cartilage regeneration after high tibial osteotomy for knees with medial compartment osteoarthritis: clinical and arthroscopic observations. Arthroscopy 2002; 18: 725-729
    CrossrefPubMedGoogle Scholar
  • 40 Petersen W, Forkel P, Achtnich A. [Chronic patellofemoral instability]. Unfallchirurg 2012; 115: 397-409
    CrossrefPubMedGoogle Scholar
  • 41 Batiste DL, Kirkley A, Laverty S et al. Ex vivo characterization of articular cartilage and bone lesions in a rabbit ACL transection model of osteoarthritis using MRI and micro-CT. Osteoarthr Cartil 2004; 12: 986-996
    CrossrefPubMedGoogle Scholar
  • 42 Funakoshi Y, Hariu M, Tapper JE et al. Periarticular ligament changes following ACL/MCL transection in an ovine stifle joint model of osteoarthritis. J Orthop Res 2007; 25: 997-1006
    CrossrefPubMedGoogle Scholar
  • 43 Harris JD, Cavo M, Brophy R et al. Biological knee reconstruction: a systematic review of combined meniscal allograft transplantation and cartilage repair or restoration. Arthroscopy 2011; 27: 409-418
    CrossrefPubMedGoogle Scholar
  • 44 Manske RC, Prohaska D, Lucas B. Recent advances following anterior cruciate ligament reconstruction: rehabilitation perspectives: Critical reviews in rehabilitation medicine. Curr Rev Musculoskelet Med 2012; 5: 59-71
    CrossrefPubMedGoogle Scholar
  • 45 Stärke C, Kopf S, Petersen W et al. Meniscal repair. Arthroscopy 2009; 25: 1033-1044
    PubMedGoogle Scholar
  • 46 Clegg DO, Reda DJ, Harris CL et al. Glucosamine chondroitin sulfate and the two in combination for painful knee osteoarthritis. N Engl J Med 2006; 354: 795-808
    CrossrefPubMedGoogle Scholar
  • 47 Bellamy N, Campbell J, Welch V et al. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2009; (2) CD005321
    PubMedGoogle Scholar
  • 48 Bellamy N, Campbell J, Robinson V et al. Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2006; (2) CD005328
    PubMedGoogle Scholar
  • 49 Day B. The indications for arthroscopic debridement for osteoarthritis of the knee. Orthop Clin North Am 2005; 36: 413-417
    CrossrefPubMedGoogle Scholar
  • 50 Hangody L, Feczkó P, Bartha L et al. Mosaicplasty for the treatment of articular defects of the knee and ankle. Clin Orthop Relat Res 2001; S328-S336
    PubMedGoogle Scholar
  • 51 Hangody L, Vásárhelyi G, Hangody LR et al. Autologous osteochondral grafting – technique and long-term results. Injury 2008; 39 (Suppl. 01) S32-S39
    CrossrefPubMedGoogle Scholar
  • 52 Frosch K-H, Voss M, Walde T et al. [A minimally invasive dorsal approach to the medial femoral condyle as a donor site for osteochondral transfer procedures]. Oper Orthop Traumatol 2010; 22: 212-220
    CrossrefPubMedGoogle Scholar
  • 53 Feczkó P, Hangody L, Varga J et al. Experimental results of donor site filling for autologous osteochondral mosaicplasty. Arthroscopy 2003; 19: 755-761
    PubMedGoogle Scholar
  • 54 Duchow J, Hess T, Kohn D. Primary stability of press-fit-implanted osteochondral grafts. Influence of graft size repeated insertion and harvesting technique. Am J Sports Med 2000; 28: 24-27
    PubMedGoogle Scholar
  • 55 Gomoll AH, Filardo G, de Girolamo L et al. Surgical treatment for early osteoarthritis. Part I: cartilage repair procedures. Knee Surg Sports Traumatol Arthrosc 2012; 20: 450-466
    CrossrefPubMedGoogle Scholar
  • 56 Mithoefer K, Hambly K, Villa Della S et al. Return to sports participation after articular cartilage repair in the knee: scientific evidence. Am J Sports Med 2009; 37 (Suppl. 01) 167S-176S
    CrossrefPubMedGoogle Scholar
  • 57 Vad VB, Bhat AL, Sculco TP et al. Management of knee osteoarthritis: knee lavage combined with hylan versus hylan alone. Arch Phys Med Rehabil 2003; 84: 634-637
    PubMedGoogle Scholar
  • 58 Hangody L, Füles P. Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am 2003; 85 (Suppl. 02) 25-32
    PubMedGoogle Scholar
  • 59 Bentley G, Biant LC, Carrington RWJ et al. A prospective randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br 2003; 85: 223-230
    CrossrefPubMedGoogle Scholar
  • 60 Marcacci M, Kon E, Delcogliano M et al. Arthroscopic autologous osteochondral grafting for cartilage defects of the knee: prospective study results at a minimum 7-year follow-up. Am J Sports Med 2007; 35: 2014-2021
    CrossrefPubMedGoogle Scholar
  • 61 Dozin B, Malpeli M, Cancedda R et al. Comparative evaluation of autologous chondrocyte implantation and mosaicplasty: a multicentered randomized clinical trial. Clin J Sport Med 2005; 15: 220-226
    CrossrefPubMedGoogle Scholar
  • 62 Mithoefer K, Williams RJ, Warren RF et al. The microfracture technique for the treatment of articular cartilage lesions in the knee. A prospective cohort study. J Bone Joint Surg Am 2005; 87: 1911-1920
    CrossrefPubMedGoogle Scholar
  • 63 Frisbie DD, Morisset S, Ho CP et al. Effects of calcified cartilage on healing of chondral defects treated with microfracture in horses. Am J Sports Med 2006; 34: 1824-1831
    CrossrefPubMedGoogle Scholar
  • 64 Knutsen G, Engebretsen L, Ludvigsen TC et al. Autologous chondrocyte implantation compared with microfracture in the knee. A randomized trial. J Bone Joint Surg Am 2004; 86: 455-464
    CrossrefPubMedGoogle Scholar
  • 65 Asik M, Ciftci F, Sen C et al. The microfracture technique for the treatment of full-thickness articular cartilage lesions of the knee: midterm results. Arthroscopy 2008; 24: 1214-1220
    CrossrefPubMedGoogle Scholar
  • 66 de Windt TS, Concaro S, Lindahl A et al. Strategies for patient profiling in articular cartilage repair of the knee: a prospective cohort of patients treated by one experienced cartilage surgeon. Knee Surg Sports Traumatol Arthrosc 2012; Jan 14 [Epub ahead of print]
    PubMedGoogle Scholar
  • 67 Mithoefer K, McAdams T, Williams RJ et al. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med 2009; 37: 2053-2063
    CrossrefPubMedGoogle Scholar
  • 68 Steadman JR, Rodkey WG, Briggs KK et al. [The microfracture technic in the management of complete cartilage defects in the knee joint]. Orthopäde 1999; 28: 26-32
    PubMedGoogle Scholar
  • 69 Miller BS, Steadman JR, Briggs KK et al. Patient satisfaction and outcome after microfracture of the degenerative knee. J Knee Surg 2004; 17: 13-17
    Article in Thieme ConnectPubMedGoogle Scholar
  • 70 Mithoefer K, Gill TJ, Cole BJ et al. Clinical outcome and return to competition after microfracture in the athleteʼs knee: an evidence-based systematic review. Cartilage 2010; 1: 113-120
    CrossrefPubMedGoogle Scholar
  • 71 Miller B, Briggs K, Downie B. Clinical outcomes following the microfracture procedure for chondral defects of the knee. Cartilage 2010; 1: 108-112
    CrossrefPubMedGoogle Scholar
  • 72 Bedi A, Feeley BT, Williams RJ. Management of articular cartilage defects of the knee. J Bone Joint Surg Am 2010; 92: 994-1009
    CrossrefPubMedGoogle Scholar
  • 73 McNickle AG, Provencher MT, Cole BJ. Overview of existing cartilage repair technology. Sports Med Arthrosc 2008; 16: 196-201
    CrossrefPubMedGoogle Scholar
  • 74 Steinwachs MR, Guggi T, Kreuz PC. Marrow stimulation techniques. Injury 2008; 39 (Suppl. 01) S26-S31
    CrossrefPubMedGoogle Scholar
  • 75 Farr J, Cole B, Dhawan A et al. Clinical cartilage restoration: evolution and overview. Clin Orthop Relat Res 2011; 469: 2696-2705
    CrossrefPubMedGoogle Scholar
  • 76 Gille J, Schuseil E, Wimmer J et al. Mid-term results of Autologous Matrix-Induced Chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 2010; 18: 1456-1464
    CrossrefPubMedGoogle Scholar
  • 77 Kon E, Delcogliano M, Filardo G et al. Novel nano-composite multilayered biomaterial for osteochondral regeneration: a pilot clinical trial. Am J Sports Med 2011; 39: 1180-1190
    CrossrefPubMedGoogle Scholar
  • 78 Kon E, Delcogliano M, Filardo G et al. Novel nano-composite multi-layered biomaterial for the treatment of multifocal degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 2009; 17: 1312-1315
    CrossrefPubMedGoogle Scholar
  • 79 Brittberg M, Lindahl A, Nilsson A et al. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 1994; 331: 889-895
    CrossrefPubMedGoogle Scholar
  • 80 Horas U, Schnettler R, Pelinkovic D et al. [Osteochondral transplantation versus autogenous chondrocyte transplantation. A prospective comparative clinical study]. Chirurg 2000; 71: 1090-1097
    CrossrefPubMedGoogle Scholar
  • 81 Driesang IM, Hunziker EB. Delamination rates of tissue flaps used in articular cartilage repair. J Orthop Res 2000; 18: 909-911
    CrossrefPubMedGoogle Scholar
  • 82 Peterson L, Vasiliadis HS, Brittberg M et al. Autologous chondrocyte implantation: a long-term follow-up. Am J Sports Med 2010; 38: 1117-1124
    CrossrefPubMedGoogle Scholar
  • 83 Anderson A, Fu F, Mandelbaum B et al. A controlled study of autologous chondrocyte implantation versus microfracture for articular cartilage lesions of the femur. Transactions of the 70th Annual Meeting of the American Academy of Orthopaedic Surgeons; 2003 February 5–9; New Orleans, LA, USA:
    PubMedGoogle Scholar
  • 84 Bentley G, Biant LC, Vijayan S et al. Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus mosaicplasty for symptomatic articular cartilage lesions of the knee. J Bone Joint Surg Br 2012; 94: 504-509
    CrossrefPubMedGoogle Scholar
  • 85 Knutsen G, Drogset JO, Engebretsen L et al. A randomized trial comparing autologous chondrocyte implantation with microfracture. Findings at five years. J Bone Joint Surg Am 2007; 89: 2105-2112
    CrossrefPubMedGoogle Scholar
  • 86 Marcacci M, Zaffagnini S, Kon E et al. Arthroscopic autologous chondrocyte transplantation: technical note. Knee Surg Sports Traumatol Arthrosc 2002; 10: 154-159
    CrossrefPubMedGoogle Scholar
  • 87 Erggelet C, Holz J, Lahm A et al. [Matrix-augmented autologous chondrocyte implantation in the knee – arthroscopic technique]. Oper Orthop Traumatol 2008; 20: 199-207
    CrossrefPubMedGoogle Scholar
  • 88 Nehrer S, Dorotka R, Domayer S et al. Treatment of full-thickness chondral defects with hyalograft C in the knee: a prospective clinical case series with 2 to 7 yearsʼ follow-up. Am J Sports Med 2009; 37 (Suppl. 01) 81S-87S
    CrossrefPubMedGoogle Scholar
  • 89 Kon E, Gobbi A, Filardo G et al. Arthroscopic second-generation autologous chondrocyte implantation compared with microfracture for chondral lesions of the knee: prospective nonrandomized study at 5 years. Am J Sports Med 2009; 37: 33-41
    CrossrefPubMedGoogle Scholar
  • 90 Minas T, Gomoll AH, Rosenberger R et al. Increased failure rate of autologous chondrocyte implantation after previous treatment with marrow stimulation techniques. Am J Sports Med 2009; 37: 902-908
    CrossrefPubMedGoogle Scholar
  • 91 Minas T. Autologous chondrocyte implantation for focal chondral defects of the knee. Clin Orthop Relat Res 2001; 391 (Suppl.) S349-S361
    CrossrefPubMedGoogle Scholar
  • 92 Kreuz P, Steinwachs M, Erggelet C. Classification of graft hypertrophy after autologous chondrocyte implantation of full-thickness chondral defects in the knee. Osteoarthrit Cartilage 2007; 15: 1339-1347
    CrossrefPubMedGoogle Scholar
  • 93 Micheli LJ, Browne JE, Erggelet C et al. Autologous chondrocyte implantation of the knee: multicenter experience and minimum 3-year follow-up. Clin J Sport Med 2001; 11: 223-228
    CrossrefPubMedGoogle Scholar
  • 94 Villa SD, Kon E, Filardo G et al. Does intensive rehabilitation permit early return to sport without compromising the clinical outcome after arthroscopic autologous chondrocyte implantation in highly competitive athletes?. Am J Sports Med 2010; 38: 68-77
    CrossrefPubMedGoogle Scholar
  • 95 Mithoefer K. Cartilage rehabilitation: Global concepts for successful joint restoration. Special Focus: Rehabilitation. ICRS Newsletter 2011; Winter Issue 14: 27-46
    PubMedGoogle Scholar
  • 96 Brittberg M. Cell carriers as the next generation of cell therapy for cartilage repair: a review of the matrix-induced autologous chondrocyte implantation procedure. Am J Sports Med 2010; 38: 1259-1271
    CrossrefPubMedGoogle Scholar
  • 97 Zheng M-H, Willers C, Kirilak L et al. Matrix-induced autologous chondrocyte implantation (MACI): biological and histological assessment. Tissue Eng 2007; 13: 737-746
    CrossrefPubMedGoogle Scholar
  • 98 Lim H-C, Bae J-H, Song S-H et al. Current treatments of isolated articular cartilage lesions of the knee achieve similar outcomes. Clin Orthop Relat Res 2012; Mar 16 [Epub ahead of print]
    PubMedGoogle Scholar
  • 99 Basad E, Ishaque B, Bachmann G et al. Matrix-induced autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee: a 2-year randomised study. Knee Surg Sports Traumatol Arthrosc 2010; 18: 519-527
    CrossrefPubMedGoogle Scholar
  • 100 Levine DW, Roaf PL, Duguay SJ. Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture. Am J Sports Med 2009; 37: e3 author reply e4
    PubMedGoogle Scholar
  • 101 Hintermann B, Boss A, Schäfer D. Arthroscopic findings in patients with chronic ankle instability. Am J Sports Med 2002; 30: 402-409
    PubMedGoogle Scholar
  • 102 Zengerink M, Struijs PAA, Tol JL et al. Treatment of osteochondral lesions of the talus: a systematic review. Knee Surg Sports Traumatol Arthrosc 2010; 18: 238-246
    CrossrefPubMedGoogle Scholar
  • 103 Niemeyer P, Salzmann G, Schmal H et al. Autologous chondrocyte implantation for the treatment of chondral and osteochondral defects of the talus: a meta-analysis of available evidence. Knee Surg Sports Traumatol Arthrosc 2011; Oct 30 [Epub ahead of print]
    PubMedGoogle Scholar
  • 104 Kuettner KE, Cole AA. Cartilage degeneration in different human joints. Osteoarthr Cartil 2005; 13: 93-103
    CrossrefPubMedGoogle Scholar
  • 105 Domayer SE, Apprich S, Stelzeneder D et al. Cartilage repair of the ankle: first results of T2 mapping at 7.0 T after microfracture and matrix associated autologous cartilage transplantation. Osteoarthr Cartil 2012; Apr 26 [Epub ahead of print]
    PubMedGoogle Scholar
  • 106 Yen Y-M, Kocher MS. Chondral lesions of the hip: microfracture and chondroplasty. Sports Med Arthrosc 2010; 18: 83-89
    CrossrefPubMedGoogle Scholar
  • 107 Philippon MJ, Schenker ML, Briggs KK et al. Can microfracture produce repair tissue in acetabular chondral defects?. Arthroscopy 2008; 24: 46-50
    PubMedGoogle Scholar
  • 108 Fontana A, Bistolfi A, Crova M et al. Arthroscopic treatment of hip chondral defects: autologous chondrocyte transplantation versus simple debridement – a pilot study. Arthroscopy 2012; 28: 322-329
    PubMedGoogle Scholar
  • 109 Ansah P, Vogt S, Ueblacker P et al. Osteochondral transplantation to treat osteochondral lesions in the elbow. J Bone Joint Surg Am 2007; 89: 2188-2194
    CrossrefPubMedGoogle Scholar
  • 110 Micheli L, Curtis C, Shervin N. Articular cartilage repair in the adolescent athlete: is autologous chondrocyte implantation the answer?. Clin J Sport Med 2006; 16: 465-470
    CrossrefPubMedGoogle Scholar
  • 111 Frank RM, Van Thiel GS, Slabaugh MA et al. Clinical outcomes after microfracture of the glenohumeral joint. Am J Sports Med 2010; 38: 772-781
    CrossrefPubMedGoogle Scholar
  • 112 Millett PJ, Huffard BH, Horan MP et al. Outcomes of full-thickness articular cartilage injuries of the shoulder treated with microfracture. Arthroscopy 2009; 25: 856-863
    PubMedGoogle Scholar
  • 113 Wakitani S, Imoto K, Yamamoto T et al. Human autologous culture expanded bone marrow mesenchymal cell transplantation for repair of cartilage defects in osteoarthritic knees. Osteoarthr Cartil 2002; 10: 199-206
    CrossrefPubMedGoogle Scholar
  • 114 Lee EH, Hui JHP. The potential of stem cells in orthopaedic surgery. J Bone Joint Surg Br 2006; 88: 841-851
    CrossrefPubMedGoogle Scholar
  • 115 Gobbi A, Karnatzikos G, Scotti C et al. One-step cartilage repair with bone marrow aspirate concentrated cells and collagen matrix in full-thickness knee cartilage lesions: results at 2-year follow-up. Cartilage 2011; 2: 286-299
    CrossrefPubMedGoogle Scholar
  • 116 Hui JHP, Chen F, Thambyah A et al. Treatment of chondral lesions in advanced osteochondritis dissecans: a comparative study of the efficacy of chondrocytes mesenchymal stem cells periosteal graft and mosaicplasty (osteochondral autograft) in animal models. J Pediatr Orthop 2004; 24: 427-433
    CrossrefPubMedGoogle Scholar
  • 117 Nejadnik H, Hui JH, Feng Choong EP et al. Autologous bone marrow-derived mesenchymal stem cells versus autologous chondrocyte implantation: an observational cohort study. Am J Sports Med 2010; 38: 1110-1116
    CrossrefPubMedGoogle Scholar
  • 118 Dow RB. The clinical and laboratory utility of platelet volume parameters. Aust J Med Sci 1994; 15: 118-125
    PubMedGoogle Scholar
  • 119 Krüger JP, Hondke S, Endres M et al. Human platelet-rich plasma stimulates migration and chondrogenic differentiation of human subchondral progenitor cells. J Orthop Res 2012; 30: 845-852
    CrossrefPubMedGoogle Scholar
  • 120 Filardo G, Kon E, Buda R et al. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2011; 19: 528-535
    CrossrefPubMedGoogle Scholar
  • 121 Longo UG, Petrillo S, Franceschetti E et al. Stem cells and gene therapy for cartilage repair. Stem Cells Int 2012; 2012: 1-9
    PubMedGoogle Scholar