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Arthritis und Rheuma 2005; 25(06): 317-322
DOI: 10.1055/s-0037-1618523
Knorpelschäden
Schattauer GmbH

Tissue Engineering von Gelenkknorpel

Tissue engineering of articular cartilage
Ulrich Schneider
1   Arthro NovaClinic, Rottach-Egern
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Publication History

Publication Date:
23 December 2017 (online)

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Zusammenfassung

Der ausgereifte hyaline Gelenkknorpel hat nach traumatischen oder degenerativen Schädigungen eine nur sehr eingeschränkte Fähigkeit zur Regeneration. Aus diesem Grund sind in der Vergangenheit verschiedene operative Tech-niken entwickelt worden, um die Knorpelreparation zu stimulieren. Die Methode der autologen Chondrozytentrans-plantation (ACT) erregte auf Grundderguten histologischen Ergebnisse des neugebildeten Reparationsgewebes zwar sehr viel Aufsehen, die eingesetzte Technik ist allerdings sehr anspruchsvoll und mit einigen gravierenden zellbiologischen und operationstechnischen Problemen vergesellschaftet. Aus diesen Gründen wurden Trägermaterialien entwickelt, welche den sicheren Transfer in den Defekt gewährleisten und die Knorpelreparation fördern. In den letz-ten Jahren wurde eine Vielzahl von unterschiedlichen Ma-terialien und Methoden tierexperimentell getestet. Aller-dings waren die Ergebnisse nur bei wenigen Materialien so zufriedenstellend, dasssie auch klinisch eingesetztwurden. Die einzelnen Materialien haben in der vorliegenden Form einige Vorteile, aber auch gravierende Nachteile, welche die Applikation teilweise in Frage stellen. Bisher existieren nur wenige klinische Studien, die den Einsatz dieser Mate-rialien in ausreichender Weise dokumentieren. Insbesondere gibt es keine Vergleichsstudien, die diese neuen Mate-rialien untereinander untersuchen und schon gar keine Langzeitstudien. Die Anwendung dieser neuen Knorpelersatzmaterialien sollte in der jetzigen Phase nur an Zen-tren erfolgen, die sich sowohl methodisch als auch wissenschaftlich mit diesem Thema auseinandersetzen.

Summary

Adult articular cartilage has a limited capacity to repair traumatic or degenerative demages. Various techniques have been introduced to improve cartilage repair. The concept of autologous chondrocyte transplantation with favourable histological results of the repair tissue has gained much attraction. However, the surgical technique is very demanding and accompanied by some major biological and technical problems. Thus, new artificial scaffolds have been developed which provide a safe transfer of the cultured tissue into the cartilage defect and ultimately support the repair process. In recent years, a variety of artificial matrices have been tested in animal studies. However, only few matrices revealed properties which finally led to clinical studies. So far, the matrices have both advantages and major disadvantages, which may threaten the clinical application. Until now, only few studies are available with a sufficient documentation of the application of these new materials. In particular, there are no comparative studies of the various matrices, and there are no longitudinal studies. At present, the clinical application of the new scaffolds should be limited to those centres with practical and scientific expertise.

Schlüsselwörter

Tissue Engineering - Knorpel - ACT - Matrix

Keywords

Tissue engineering - cartilage - ACT - matrix
 

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