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Cartilage Surgery

With increasing age, due to degenerative process the quality of the hip joint cartilage decreases. In the initial phase the symptoms may occur as load-dependend pain after long period load. At this stage various conservative treatments are available, e.g. balanced diet, special sports, treatments by medication. With an increasing number of complaints (e.g.: night pain) which affect the patientspecific quality of life further surgical treatments come into question.

Depending on the extent of the cartilage damage several operational methods are offered. In case of deeper defects, located at the femoral head or the articular cavity, multiple micro-fructures are conducted. Thereby damaged cartilage is removed and the bone underneath is opened up. In later stages together, the leaking blood and stem cells form a former cartilage replacement which enables increasing load. Often, in addition to the microfracture, a collagen membrane ( AMIC, matrix-induced chondrogenesis) is used to prevent a wash away of the blood and stem cells (Figure 1).

Figure 1: AMIC Treatment at the articular cavity (* ChondroGide, housed inside a defect)

Due to a movement treatment cartilage can regenerate. 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.