Rekonstruktion traumatischer Gelenkflächendefekte

Zusammenfassung

Traumatische Gelenkflächendefekte entstehen durch Trauma, Tumor, entzündliche oder degenerative Gelenkerkrankungen und nach der Explantation orthopädischer Implantate. Die Defektdeckung kann bei fehlender Kontraindikation durch autologen oder allogenen Knochen, osteochondrale Transplantate oder vaskularisierte Implantate erfolgen. Eine neue Therapieoption ist bei ausgedehnten Defekten die Implantation maßgefertigter Hybridimplantate aus autologem Knochen und in vitro kultivierten Knorpelzellen. Dieser Artikel gibt einen Überblick über die Pathogenese und die Vor- und Nachteile der verschiedenen Therapieoptionen.

Summary

Traumatic joint surface defects are a result of trauma, tumour, inflammatory or degenerative joint desease. They occur after explantation of orthopaedic implants. If contraindications are ruled out, defect coverage can be accomplished by the implantation of autologeous or allogeneic bone, osteochondral or vascularized implants. A novel therapy represents the implantation of custom made hybrid implants out of autologeous bone and in-vitro cultivated cartilage cells. This article provides an overview of the state of the art with the advantages and disadvantages of the various therapeutic options.

Schlüsselwörter

Gelenkflächendefekt - autologer Knochen - allogener Knochen - osteochondrales Transplantat - vaskularisiertes Implantat - Hybridimplantat

Keywords

Traumatic joint surface defects - autologeous bone - allogeneic bone - osteochondral implant - vascularized implant - hybrid implant

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