Handlungsempfehlung: Knorpeltherapie am Kniegelenk

Niemeyer, Philipp; Faber, Svea; Bumberger, Alexander

doi:10.1007/s43205-021-00140-w

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…20 However, the longitudinal observation over time (Figure 6) in the present study did not show an increase in the proportion of Matrix-BMS treatments in the German Cartilage Registry. Since Matrix-BMS was suggested as alternative treatment to ACI for the treatment of mid-sized cartilage lesions, 40 the present analysis was extended by a logistic regression analysis to identify independent factors influencing treatment choice toward ACI or Matrix-BMS. The analysis revealed that higher patient age, full-thickness corresponding cartilage lesions, and concomitant osteotomies or meniscal therapies made the use of Matrix-BMS more likely in this group.…”

Section: Choice Of Treatment Methodsmentioning

confidence: 99%

Factors Affecting Choice of Surgical Treatment of Cartilage Lesions of the Knee: An Analysis of Data From 5143 Patients From the German Cartilage Registry (KnorpelRegister DGOU)

Gebhardt,

Vollmer,

Zimmerer

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: Symptomatic full-thickness cartilage lesions of the knee joint are considered an indication for cartilage repair surgery. Patient- and lesion-specific factors like age, nutritional status, etiology of defect, or integrity of corresponding joint surface remain controversial in indicating cartilage repair surgery. Furthermore, the selection of the most suitable cartilage repair technique for a specific cartilage lesion remains debatable. Purpose: To evaluate indications and choice of treatment method for cartilage repair surgery, depending on patient- and lesion-specific data from the German Cartilage Registry. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 6305 consecutive patients who underwent cartilage repair surgery of the knee evaluated and 5143 complete datasets were included in the analysis (follow-up rate, 81.5%). Patient-specific (age, body mass index, smoking status, previous operations, clinical leg axis) and lesion-specific (size, grading, location, etiology) data were provided by the attending surgeon at the time of surgery. Appropriate statistical tests were used to compare data depending on type and normality of data. Multivariable logistic regressions were calculated to investigate independent factors for the choice of specific cartilage repair techniques. Results: The median size of treated cartilage lesions was 3.6 cm2, and most defects were of degenerative origin (54.8%). Of the registered patients, 39.2% were categorized as overweight and 19.6% as obese, while 23.3% were smokers. The most prevalently documented operative techniques were the autologous chondrocyte implantation (ACI) (52.4%), bone marrow stimulation (BMS) (17.3%), and BMS augmented with collagen scaffolds (9.3%). Independent factors that made the use of ACI more likely were bigger lesion size, previous surgery at the joint, and lesions located at the trochlea or the patella. On the contrary, BMS or augmented BMS were preferred in older patients, with damaged corresponding joint surface, and with more concomitant surgeries. Conclusion: Cartilage repair surgery was indicated irrespective of nutritional status, smoking status, or etiology of the treated lesion. ACI was the most prevalent technique and was preferred for younger patients and patellar lesions. While older patients with degenerative changes to the joint were not excluded from cartilage repair surgery, the use of ACI was restricted.

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Section: Choice Of Treatment Methodsmentioning

confidence: 99%

Factors Affecting Choice of Surgical Treatment of Cartilage Lesions of the Knee: An Analysis of Data From 5143 Patients From the German Cartilage Registry (KnorpelRegister DGOU)

Gebhardt,

Vollmer,

Zimmerer

et al. 2024

Orthopaedic Journal of Sports Medicine

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“…Kenntnis der Ursachen ist wichtig. Aufgabe des behandelnden Arztes ist es, sich zunächst der Ursachenanalyse zu widmen [15]. Achsfehlstellungen und/oder Instabilitäten spielen hierbei eine wichtige Rolle und müssen konsequent im Rahmen einer geplanten Knorpeltherapie mit adressiert werden.…”

Section: Prinzipien Der Operativen Knorpelregenerativen Therapieunclassified

“…Für die Behandlung fokaler Knorpelschäden bei intakten Menisken und stabilem Bandapparat stehen mittlerweile gute Operationstechniken zur Verfügung [15], die auch mit einer hohen Rate an postoperativen Rückkehrern in den Sport assoziiert sind [11]. Für die Behandlung einer fortgeschrittenen degenerativen Gelenkerkrankung wie einer Arthrose gilt dies nach wie vor leider nicht.…”

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