Das KnorpelRegister DGOU zur Erfassung von Behandlungsergebnissen nach Knorpeloperationen: Erfahrungen nach 6 Monaten und erste epidemiologische Daten

Abstract

The German Cartilage Registry (KnorpelRegister DGOU) has been introduced in October 2013 and aims on the evaluation of patients who underwent cartilage repair for symptomatic cartilage defects. It represents a nation-wide cohort study which has been introduced by the working group "Tissue Regeneration" of the Germany Society of Orthopaedic Surgery and Traumatology and is technically based upon a web-based remote data entry (RDE) system. The present article describes first experiences with the registry including patient and treatment characteristics. Between October 2013 and April 2014, a total of 230 patients who had undergone surgical cartilage repair for symptomatic full-thickness cartilage defects of the knee has been included in the German Cartilage Registry from 23 cartilage repair centres. Mean age was 37.11 years (SD 13.61) and mean defect size was 3.68 cm(2) (SD 0.23). Since the introduction of the KnorpelRegister DGOU the total number of registered patients has increased steadily up to the most recent figure of 72 patients within one month. Patients were treated mainly according to the recommended therapies. The highest percentage in therapy is represented by the bone marrow stimulation techniques (55.02 %) as well as by the autologous chondrocyte transplantation (34.92 %). Unlike the patient collective in the majority of prospective randomised controlled trials, the patient population within the registry shows a high proportion of patients with accompanying pathologies, with an age of more than 50 years at the time of treatment and with unfavourably assessed accompanying pathologies such as an affection of the opposite cartilage surface or a previously resected meniscus. In summary, the technical platform and forms of documentation of the KnorpelRegister DGOU have proved to be very promising within the first six months. Unlike data from other clinical trials, the previous analysis of the patients' data and therapies reflects successfully the actual medical care situation of patients with cartilage defects of the knee joint. This analysis also provides new information on subgroups of patients that have not yet been recorded in the scientific literature. This will be part of the first analysis of clinical treatment data. An expansion of the KnorpelRegister DGOU to patients with cartilage defects of the ankle and hip joints is already decided upon and initialised.

Physioxia Expanded Bone Marrow Derived Mesenchymal Stem Cells Have Improved Cartilage Repair in an Early Osteoarthritic Focal Defect Model

“…According to the Deutsche Gesellschaft fur Orthopaedie und Unfallchirurgie (DGOU) registry between October 2013 and June 2014, 60% of treated defects were degenerative. In a multi-centre study from 400 patients, approximately 35% had chondral lesions resulting from degenerative conditions [4,5]. Current strategies for the treatment of cartilage lesions have involved the use of surgical intervention (e.g., microfracture) or cell-based therapies [6].…”

The Importance of Physioxia in Mesenchymal Stem Cell Chondrogenesis and the Mechanisms Controlling Its Response

“…It has been noted that there is an increased risk of OA within the knee joint due to previous joint injury (e.g., anterior cruciate ligament (ACL) injury), excessive repetitive loading, joint dysplasia and meniscectomy. According to the German Cartilage Registry (Deutsche Gesellschaft für Orthopäedie und Unfallchirurgie (DGOU)) between October 2013–June 2014, 60% of treated cartilage defects were degenerative, whilst a recent multi-centre study showed that of 400 patients, approximately 40% had chondral injuries resulting from degenerative conditions [5,6]. In classifying the forms of OA that can be treated, recent studies have described the term “early OA” [7,8,9].…”

“…Autologous articular chondrocytes are an established cell-based tissue engineering strategy for treatment of large “focal traumatic” or “focal early OA” chondral or osteochondral defects of the knee joint [6,11,12]. Mesenchymal stem cells (MSCs) can be isolated from a variety of sources including bone marrow, adipose (liposuction or intrapatellar fat pad) or synovium with minimal donor site morbidity [13,14,15,16] and have been shown to have chondrogenic potential, initially in vitro with the creation of pellets or micromasses and the addition of the stimulatory growth factor, transforming growth factor-beta (TGF-β) [17,18].…”

A Registry for Evaluation of Efficiency and Safety of Surgical Treatment of Cartilage Defects: The German Cartilage Registry (KnorpelRegister DGOU)

“…Among these are university medical centers and private hospitals, doctors’ surgeries, and outpatient surgical centers. As of January 31, 2016, a total of 2124 patients have been registered (see Figure 3 ) and the first clinical results have been published [ 40 - 42 ].…”