Award "Jahresbestpreis OUP" presented to Prof. Dr. Wolf Petersen and his team
The journal "Orthopädische und Unfallchirurgische Praxis“ („Orthopaedic and Trauma Practice") in collaboration with the publishing house Deutsche Ärzteverlag and the VSOU (South German Association of Orthopaedic and Trauma Surgeons) awards this year for the first time the „Jahresbestpreis OUP“ („Best of the Year Award OTP“). The award goes to Prof. Dr. Wolf Petersen, head of the Department of Orthopedics and Traumatology at Martin Luther Hospital and his team of authors. The article is about "Techniques to grow and use regenerated material for the treatment of local cartilage defects: microfracture and matrix-induced chondrogenesis" (published in the February-issue of OP of 2011).
The contents of the article at a glance: The hyaline articular cartilage has an important function in the joints of the musculoskeletal system, because it allows the transmission of forces while ensuring the smooth movement of the joint parts. For this reason, cartilage damage can lead to a strong function limitation and in the long term, depending on the size of it, even in an osteoarthritis. For an athlete, a symptomatic cartilage damage can spell the end of his competitive career.
Since cartilage is avascular, that means it contains no blood vessels and can therefore not supplied, it has a poor healing potential. For this reason, the therapeutic options for symptomatic cartilage damage have long been limited. In the article by Prof. Petersen and his team, techniques are presented, which stimulate the regeneration of subchondral bone formation.
The Award and prize money will be presented during the 60. Annual Conference of the VSOU in Baden-Baden which will take place from April, 28th to May, 1st 2012.
How the techniques for the treatment of local cartilage defects work – Summary:
The principle of techniques to grow and use regenerated material is based on an opening of the subchondral marrow space to provoke bleeding. After some time replacement tissue will form from the blood clots, which is consistent with histologically fibrocartilage. From the marrow space pluripotent stem cells shall wander into the defect. There, in the organ-specific environment they differentiate themselves into chondrocytes.
The most gentle opening of the subchondral bone is possible by microfracturing. This method is suitable for local, small, shoulder-cartilage damage at the medial or lateral femoral condyle in young patients with low body mass index. When it comes to active athletes after initial successes a worsening of symptoms can occur after several months. Even in cases of degenerative joint damage, microfracturing is suggested. With instabilities or deformities techniques to grow and use regenerated material should be combined with corrective surgery or ligament replacement surgery. In prospective randomized trials no difference could be detected to the result after autologous chondrocyte implantation.
The matrix-induced chondrogenesis is a new surgical procedure in which the tissue differentiation is to be improved by the application of a matrix in the freshened defect. This process is also possible arthroscopically. Long-term results and prospective randomized trials are still pending.