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Autologous Chondrocyte Transplantation (ACT)

The Arthroscopical ACT (Autologous Chondrocyte Transplantation) is a promosing method for the treatment of local cartilage defects, that consists of two procedures. In the first part of the surgical treatment autologous cartilage cells (chondrocytes) are removed arthroscopically. In a complex process this cartilage cells can be cultured, which makes it possible to produce large numbers of multicellular spheroids. These spheroids contain approximatly 200000 cartilage cells and have a diameter of 0,5-0,7 mm (Figure 1). During a second operation the spheroids are reintroduced into the defect (Figure 2).
Another special feature of this treatment is that the cutlture of the cells and the production of the spheroids is implemented with autologous blood serum. As a result side effects and reactions because of alien tissue can be avoided.
In this process the cost absorption should be clarified by the payer.


Figure 1: Spheroids ready for their implanation


Figure 2: Arthrocopiaclly inserted spheroids due to an ACT

Rehabilitation
Due to a movement treatment the new cartilage cells can recreate quality cartilage. It connects with the healthy cartilage with similar biomechanical characteristics. Passive movement using a movement-sleeve (CPM) should be performed 4-6 hours a day over a 4 week period. A complete load relief is not useful and is, in case oft he hip joint, difficult since there is already a full load during seated postition. Cartilage massage in the form of ergometer training (cycling without great resistance) should be done regulary. Heavy sports activities (e.g.: Jogging and Impact-Sport) can be earliest introduced after 9-12 months. It seems reasonable to administer orally or to inject glucosamine and chondroitin sulfate directly into the joint fort he first 12 months after the operation.