Cartilage Regeneration with Cell-free Type 1 Collagen Matrix – Past, Present and Future (Part 1 – Clinical Aspects)

Philip Peter Roessler; Turgay Efe; Dieter Christian Wirtz; Frank Alexander Schildberg

doi:10.1055/a-1200-2765

Zeitschrift für Orthopädie und Unfallchirurgie, Table of Contents

Z Orthop Unfall 2021; 159(06): 607-616
DOI: 10.1055/a-1200-2765

Review/Übersicht

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

Article in several languages: English | deutsch

Philip Peter Roessler

¹OPM – Orthopädische Praxisklinik Mayen

²Medical Faculty, Orthopaedics and Trauma Surgery, Rheinische Friedrich-Wilhelms-Universität Bonn

,

Turgay Efe

³Orthopaedicum Lich

⁴Medical Faculty, Orthopaedics and Trauma Surgery, Philipps-Universität Marburg

,

Dieter Christian Wirtz

⁵Department of Orthopaedics and Trauma Surgery, University Hospital Bonn

,

Frank Alexander Schildberg

⁵Department of Orthopaedics and Trauma Surgery, University Hospital Bonn

› Author Affiliations

Abstract

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

Full Text

References

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