Cartilage Transplantation

Synonyms

  • Autologous Chondrocyte Transplantation (ACT)
  • Autologous Chondrocyte Implantation (ACI)
  • Autologous cartilage cell transplantation (AKZT)

Cartilage is a type of connective tissue that occurs in the body in different places – for example, in the nasal malleolus or auricles – but also in joints. Depending on the type of cartilage, its consistency lies somewhere between solid jelly and hard plastic, and fibrous cartilage is also present. In the joint, cartilage plays an important role as a coating for the joint surfaces: it ensures that they can slide over each other with low friction and also buffers impacts to a small extent.

Theoretically, cartilage damage in the joint (called arthrosis if it goes beyond the usual extent in old age) can also be caused by accidents (trauma) or inflammation within the joint cavity (arthritis), but far more often it is the result of years of wear and tear of the cartilage tissue in old age, or premature wear and tear due to poor posture, chronic overloading or cartilage weakness caused by congenital connective tissue defects. These cartilage damages can then cause complaints, especially when the corresponding joint is under stress, such as severe pain or joint effusions, since the bone lying under the cartilage is now exposed to the frictional forces of the joint without protection and can even crumble away. This increased cartilage damage is countered by the fact that the healing ability of the cartilage is already very limited even in healthy people, and may be even more limited in people affected by osteoarthritis. Several factors play a role here: The type of cartilage transplantation discussed here partially circumvents at least the first two points.

  • If cartilage tissue is basically not supplied with blood, the local cells responsible for repair (chondrocytes) are therefore supplied with potential building materials only very poorly;
  • Is the number of these cells quite limited (they make up only about 1% of the cartilage mass)
  • In adults, the natural tendency of these cells to make repairs at all is quite low.