Empfehlungen der AG Klinische Geweberegeneration zur Behandlung von Knorpelschäden am Kniegelenk

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Philipp Niemeyer - , Orthopädische Chirurgie München (Author)
  • Dirk Albrecht - , Medical University of Vienna (Author)
  • Matthias Aurich - , University Center for Orthopedics, Trauma and Plastic Surgery (OUPC) (Author)
  • Christoph Becher - , HKF - Internationales Zentrum für Hüft- (Author)
  • Peter Behrens - , Mathys Orthopädie GmbH (Author)
  • Peter Bichmann - , University Hospital Carl Gustav Carus Dresden (Author)
  • Gerrit Bode - , University Hospital Carl Gustav Carus Dresden (Author)
  • Peter Brucker - , Mathys Orthopädie GmbH (Author)
  • Christoph Erggelet - , alphaclinic zürich (Author)
  • Marco Ezechieli - , St. Josefs-Hospital Salzkotten (Author)
  • Svea Faber - , Orthopädische Chirurgie München (Author)
  • Stefan Fickert - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Jürgen Fritz - , German Society for Orthopaedic and Trauma Surgery (DGOU) (Author)
  • Arnd Hoburg - , Gelenk- und Wirbelsäulenzentrum (Author)
  • Peter Kreuz - , University Hospital Carl Gustav Carus Dresden (Author)
  • Jörg Lützner - , University Center for Orthopedics, Trauma and Plastic Surgery (Author)
  • Henning Madry - , University Hospital of Saarland (Author)
  • Stefan Marlovits - , University Hospital Carl Gustav Carus Dresden (Author)
  • Julian Mehl - , Abteilung und Poliklinik für Sportorthopädie (Author)
  • Peter E Müller - , Asklepios Orthopaedic Clinic Hohwald (Author)
  • Stefan Nehrer - , Fakultät für Gesundheit und Medizin (Author)
  • Thomas Niethammer - , University Hospital Carl Gustav Carus Dresden (Author)
  • Matthias Pietschmann - , Asklepios Orthopaedic Clinic Hohwald (Author)
  • Christian Plaass - , Diakovere Hospital (Author)
  • Philip Rössler - , University Hospital Carl Gustav Carus Dresden (Author)
  • Klaus Rhunau - , JIS Orthopedics (Author)
  • Bernhard Schewe - , Orthopädisch Chirurgisches Centrum (Author)
  • Gunter Spahn - , German Society for Orthopaedic and Trauma Surgery (DGOU) (Author)
  • Matthias Steinwachs - , Zentrum für Orthobiologie und Knorpelregeneration (Author)
  • Thomas Tischer - , University of Rostock (Author)
  • Martin Volz - , University Hospital Essen (Author)
  • Markus Walther - , Foot and Ankle Surgery (Author)
  • Wolfgang Zinser - , St. Vinzenz-Hospital Dinslaken (Author)
  • Johannes Zellner - , sporthopaedicum Regensburg (Author)
  • Peter Angele - , sporthopaedicum Regensburg (Author)

Abstract

The Working Group of the German Orthopedic and Trauma Society (DGOU) on Tissue Regeneration has published recommendations on the indication of different surgical approaches for treatment of full-thickness cartilage defects in the knee joint in 2004, 2013 and 2016. Based upon new scientific knowledge and new developments, this recommendation is an update based upon the best clinical evidence available. In addition to prospective randomised controlled clinical trials, this also includes studies with a lower level of evidence. In the absence of evidence, the decision is based on a consensus process within the members of the working group.The principle of making decision dependent on defect size has not been changed in the new recommendation either. The indication for arthroscopic microfracturing has been reduced up to a defect size of 2 cm2 maximum, while autologous chondrocyte implantation is the method of choice for larger cartilage defects. Additionally, matrix-augmented bone marrow stimulation (mBMS) has been included in the recommendation for defects ranging from 1 to 4.5 cm2. For the treatment of smaller osteochondral defects, in addition to osteochondral transplantation (OCT), mBMS is also recommended. For larger defects, matrix-augmented autologous chondrocyte implantation (mACI/mACT) in combination with augmentation of the subchondral bone is recommended.

Details

Original languageEnglish
Pages (from-to)57-64
Number of pages8
JournalZeitschrift fur Orthopadie und Unfallchirurgie
Volume161
Issue number1
Publication statusPublished - Feb 2023
Peer-reviewedYes

External IDs

Scopus 85148307047

Keywords

Keywords

  • Humans, Prospective Studies, Cartilage Diseases/surgery, Orthopedics, Orthopedic Procedures, Knee Joint/surgery, Chondrocytes, Cartilage, Articular/surgery