When is therapy with autologous cultivated chondrocytes suitable?
Autologous transplantation of chondrocytes cultured ‘in vitro’ is the method of choice for treating acute or chronic lesions of articular cartilage. The possibilities of repairing damaged cartilage are limited and it can cause limited and painful joint function, leading to arthrosis.
Local injuries of articular cartilage, bigger than 0,5cm2 and up to the entire thickness of cartilage to the bone (3rd and 4th degree injuries according to ICRS criteria), can be treated by implantation of cultivated autologous chondrocytes, This method is used for routine treatment of articular cartilage in knee and ankle, but rarely for other cartilage injuries. The most appropriate age of patients for this treatment is between 15 and 55 years.
Injuries to articular cartilage present a serious problem in orthopaedics and traumatology, because of the poor ability of articular cartilage to regenerate spontaneously.
Damaged hyaline cartilage regenerates only partially within the joint and most of the defect is replaced by scar (fibrous) tissue that does not possess the same biomechanical and histological properties as the healthy tissue.
Damaged articular cartilage therefore tends to lead to arthrosis. This causes pain and discomfort and reduces the functionality of the joint, often calling for surgical intervention and even replacement of the damage joint with an artificial one of limited life-span.
Surgeons therefore only implant endoprostheses on older patients. Over five hundred endoprostheses are implanted per one million people every year, and an equal number of operations are performed to alleviate pain and discomfort caused by arthrosis.
When is therapy with autologous cultivated chondrocytes not appropriate?
This form of therapy is not appropriate when the patient has at least one of the following contraindications:
Knee with totally removed meniscus; joint instability resulting from injuries of several tendons simultaneously; knee arthrosis (generalized impairment of cartilage); any form of autoimmune disease (for example, rheumatoid arthritis) or metabolic dysfunction (for example diabetes, gout); sensitivity to any of the compounds associated with cell cultivation or the cell scaffold (e.g. antibiotics, animal collagen, etc.)