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This method is indicated for isolated, small (<2 square centimeters), well defined cartilage lesions with a preserved subchondral bone layer. In this regenerative procedure, small holes are “pecked” into the defect area arthroscopically, from which mesenschymal stem cells then migrate to form regenerative cartilage tissue.
This procedure is used for larger, symptomatic cartilage defects, most commonly in the knee joint. This is a two-stage procedure. In a first arthroscopic procedure, cartilage cells are removed from a non-weightbearing marginal area of the knee joint. These are cultivated in the laboratory, propagated and applied in vitro to a biphasic matrix. This three-dimensional construct is transplanted into the cartilage defect in a second surgical procedure about 3 weeks later in a minimally invasive manner. With this procedure, defect sizes of up to approx. 14 square centimetres can be treated. If the underlying bone is also diseased (sclerosed/hardened), the base of the defect may first have to be filled with autologous bone graft, before the cartilage transplant is inserted.