Artikel
One-year-results following Matrix-assisted Autologous Chondrocyte Transplantation (MACT)
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Veröffentlicht: | 13. Juni 2005 |
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Gliederung
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Introduction
For biological reconstruction of full-thickness cartilage defects various surgical treatments are available. Especially for the treatment of defects exceeding 4cm2 Autologous Chondrocyte Transplantation (ACT) is recommended as a first-line treatment.
Beside mainly good clinical results there are some disadvantages connected with ACT: a long time of operation and an extended arthrotomy due to the watertight suturing of a periosteal graft. Those disadvantages can be avoided by using a matrix for ACT (→ "MACT"). However, the question remains if the use of a biomaterial can affect the clinical outcome on the long run.
Patients and methods
From 12/03 to 05/04 we treated 23 patients at the Berufsgenossenschaftliche Unfallklinik Tübingen with MACT (NOVOCART®3D, B.Braun-Aesculap). Follow-up took place between 12 and 17 months p.o. by x-ray, MRI and clinical examination (IKDC 2000 Score).
Results
Beside 1 complete graft failure, no complications occurred. The mean IKDC-Score was preoperatively 28,4 and increased to 77,2 after a mean follow-up period of 15 months. MRI-scans showed mainly a complete filling of the former defect.
Discussion
The results of MACT are mainly comparable to those following ACT. In addition we found the following positive effects: the postoperative pain was reduced, the average stay on ward was shortened from 11,4 to 4,2 days. The mean operation-time was reduced from 105 to 37 minutes.
According to our experience, MACT can be regarded as an improvement of this technique.
Nevertheless further results have to be awaited, whether the long-term results of MACT are as good as those following a "classical" ACT.