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Cartilage lesions

Microfracturing

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.

Matrix-associated chondrocyte transplantation (MACT)

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.