Author/Editor		Radosavljevič, Damjan; Drobnič, Matej; Koritnik, Branko; Gorenšek, Miro; Maličev, Elvira; Jeras, Matjaž; Knežević, Miomir
Title		Novosti v terapiji obolenj in poškodb sklepov: mozaična plastika in avtologna transplantacija hondrocitov
Translated title		New approach to the diseases and injuries of the joints: mosaic-plasty and autologous chondrocytes transplantation
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 40, št. 7-8
Publication year		2001
Volume		str. 216-8
Language		slo
Abstract		Articular cartilage has limited regeneration ability due to the specific structure. Even small articular surface lesions progress to the osteoarthritic deformation of the joint with the implantation of the endoprosthesis as the end result. New surgical methods for cartilage repair have been developed at the beginning of nineties. Mosaic-plasty and autologous chondrocytes transplantation were widely accepted as regular clinical procedures. Mosaic-plasty is a method of the osteochondral plugs transfer from the lesser weight-bearing areas of the joint into the defect on the major weight-bearing surface. The method had been developed for the knee first, but there have been many recent reports of spreading the procedure to the other joints. The major problems are availability of the cartilage and patient's age. Autologous chondrocytes transplantation is based on the arthroscopic removal of small cartilage pieces from the edge of the joint surface. Chondrocytes from the removed cartilage are cultivated in vitro and implanted into the defect. Treatment of focal traumatic lesions of the femoral condyles have proved to be successful in young persons. Both methods give encouraging results in the traumatic lesions of articular cartilage, but the arthrotic type of cartilage degeneration remains an unsolved issue.
Summary		Sklepni hrustanec ima zaradi specifične zgradbe omejeno sposobnost regeneracije. Že majhne poškodbe lahko vodijo v degeneracijo sklepne površine s posledično artrozo, kar običajno privede do vstavitve endoproteze. V začetku devetdesetih so se pričele razvijati nove kirurške metode za popravo hrustančnih poškodb in ustavitev degenerativnih sprememb. V razširjeni klinični uporabi sta se uveljavili mozaična plastika in avtologna transplantacija hondrocitov Pri mozaični plastiki presadimo kostno-hrustančne čepe iz manj obremenjene površine sklepa na mesto poškodbe na močno obremenjenem delu. Metoda se je pričela uporabljati na kolenu in se širi tudi na ostale sklepe. Največjo omejitev predstavljata razpoložljivost hrustančnega tkiva, primernega za presaditev, in starost bolnika. Avtolagna transplantacija hondrocitov je metoda, pri kateri artroskopsko odvzamemo koščke hrustanca na robu sklepne površine; iz njih v kulturi vzgojimo hondrocite ter jih vrnemo v sklep na mesto poškodbe. Dobre rezultate dosežemo pri mlajših ljudeh s travmatsko okvaro hrustanca na femorainem kondilu kolena. Omejitev predstavljajo velikost okvare in artrotične spremembe na mestu poškodbe. Obe metodi dajeta spodbudne rezultate pri travmatskih okvarah, medtem ko za artrotično okvaro hrustanca trenutno še nimamo ustrezne rešitve.
Descriptors		CARTILAGE, ARTICULAR OSTEOCHONDRITIS JOINT DISEASES JOINTS