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Augmented Marrow Stimulation for Cartilage Repair

  • Christoph Erggelet
Chapter

Abstract

Representing the most popular marrow stimulation technique, microfracture has been established as a gold standard for the treatment of articular cartilage defects.

In order to maintain the idea of using autologous cells for cartilage repair and to further develop the idea of an autologous one-step procedure to repair cartilage lesions, the use of resorbable scaffolds was developed with an increase of primary stability due to an initial protection of the blood clot.

Augmented marrow stimulation techniques for the treatment of cartilage defects promise the potential for:
  • Faster rehabilitation due to increased initial stability of the regenerating tissue

  • Better tissue quality since early compression and shear stress promotes chondrogenesis

  • The benefits of a single-stage procedure compared to a chondrocyte transplantation

  • Multiple future options to increase outcome quality, e.g., with growth factor augmentation or drug release

A variety of different techniques and materials are available for arthroscopic and open surgery.

The evidence for the effectiveness of the microfracture procedure alone or the scaffold augmented variation is largely derived from case series and few randomized trials – both with obvious limitations.

Maybe a new approach to clinical evidence might be necessary. International registries should be able to create comprehensive datasets at significant lower costs and administrative hurdles and therefore promote the safe and quick implementation of new developments in the field of cartilage repair.

Keywords

Cartilage repair Augmented marrow stimulation Microfracture Scaffolds 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University Medical CenterFreiburgGermany
  2. 2.Alphaclinic ZurichZurichSwitzerland

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