This is a 31 years-old physio therapist who suffered from a traumatic injury of the articular cartilage after a cycling accident. His goal is to regain range of motion as well as diminish pain, swelling and locking of joint.
Articular cartilage lesions caused by trauma, are a common pathology of the knee joint in young patients resulting in pain and function loss. In a retrospective analysis of 25,124 knee arthroscopy patients, chondral lesions were found in 60% of them. A total of 7% of all patients aged less than 40, and 9% under the age of 50 years, showed 1 to 3 localized grade III or IV cartilage defects. Full-thickness articular cartilage defects only have limited regenerative potential, and spontaneous healing is unlikely. Surgical techniques include the following:
- Palliative options including debridement and lavage.
- Reparative options including drilling/microfracture (MFx) to stimulate migration of bone marrow cells into the cartilage defect.
- Reconstructive options including osteochondral autograft transfer system (OATS®) and osteochondral allograft transplantation.
- Restorative options including autologous chondrocyte implantation (ACI®).
This case is treated with the microfracture technique, further improved by the use of a collagen matrix (AMIC). The addition of PRP and minced cartilage may biologically enhance the regeneration.
Dr. Matthias Steinwachs is Medical Director and knee specialist at SportClinic Zurich /Hirslanden, Clinic Zurich. He is a renowned international tissue regeneration specialist e.g. cartilage, meniscus etc. He is also member of the Swiss knee experts group (EGK) at the SGOT, former chairmen of the knee committee at the Society for Arthroscopy and Joint Surgery (AGA) and has a lectureship at ETH Zurich and University Freiburg.