Cartilage Transplantation (ACT)
A chondrocyte implantation or cartilage transplantion is an innovative surgical procedure that allows repairing cartilage defects with autologous articular cartilage cells. The procedure allows for new cartilage to grow at the site of the defect.
How does a cartilage transplant work?
First, cartilage cells are extracted arthroscopically from the patient's healthy cells. In a special laboratory, the cartilage cells are first propagated and subsequently imbedded into carrier membrane. This cartilage cell-containing membrane is implanted in a second surgery through a 3 to 4 cm wide incision in the damaged joint. The cartilage cells proliferate further, while the carrier membrane residue degrades (= bioresorbable). Within 8 weeks, the cartilage defect is completely refilled.
Who will benefit from cartilage transplant?
Chondrocyte transplantion is suitable for younger patients (<50 years), if a degenerative joint disease is present at an early stage, meaning if the cartilage is damaged in a specific area of the joint (Stage IV), and if there is no significant cartilage damage in other joints.
When is a chondrocyte transplantion/implantation not advisable?
Patients with a strongly pronounced arthritis, a cartilage transplantion/implantation should not undergo chondrocyte transplantion. A cartilage transplantion should also not be conducted in elderly patients, patients with pronounced X - or O-leg position, or patients with severe systemic diseases. These conditions require other measures to treat the osteoarthritis.
After the cartilage transplantion:
The joint may not be strained during the first 8 weeks after the cartilage transplantion, meaning that the patient has to use crutches with minimal weight applied to the injured leg. During this time, it is however still important that the knee is moved as often as possible. Possibly a special brace (CPM) is used that moves the leg continuously. The leg must be moved without subjecting it to any weight such as with exercies on a standard bicycle (bicycle ergometer). A gentle physical therapy will accompany the post-surgical care. After about 8 weeks normal walking without the help of crutches will be possible again. Approximately 3 months after the surgery, patients can walk, ride a bicycle or participate in cross-country skiing again without problems. Sports stressful on the joints such as tennis, soccer, serious skiing, etc. should be avoided for at least one year. After the necessary regeneration phase, the cartilage damage will have completely healed and the patient regains full ability to again participate in all sports activities.
Essential facts about a cartilage cell transplant
The cost of cell propagation and cartilage transplantion is in most cases covered by private insurance carriers. Public health insurances, however, do not cover this type of procedure. The cost of cartilage cultivation is about 5000 EUR. Whether or not your knee problems can be treated by a cartilage transplant should be discussed between you and the orthopedic surgeon and/or a specialized cartilage transplant orthopedist. For an accurate assessment, it is necessary to conduct an MRT or arthroscopy.
Specialists: Cartilage transplantion
For an optimal cartilage transplantion, the knee experts at the Klinik am Ring are particularly well-qualified. Stefan Preis, M.D. and Jörg Schroeder, M.D., senior physicians at the Practice and Department of Orthopedics and Sports Traumatology at the Klinik am Ring in Cologne, specialize together with their team in the treatment of knee and shoulder disorders. In 2004, they founded the WEST GERMAN SHOULDER KNEE & CENTER, Cologne. The team consisting of eight specialists treats more than 20,000 patients per year. The team performs more than 2500 surgeries annually. The first cartilage transplantion was conducted by the team as early as 1998.
Worth knowing