Adjuvante Injektionen nach operativer Knorpeltherapie

Adjuvant injections after cartilage surgery can comprise a variety of orthobiologics, including hyaluronic acid (HA), platelet-rich plasma (PRP), and mesenchymal stromal cell (MSC) therapy. The aim of these adjuvant therapies is to further improve postoperative results regarding cartilage defects and promote tissue regeneration. HA, a natural component of synovial fluid, offers promising results due to its shock-absorbing and anti-inflammatory properties, especially with targeted molecular customization. PRP, rich in growth factors, supports healing through anti-inflammatory and regenerative effects, whereby variations in production and administration appear to be important for therapeutic success. MSC, on the other hand, shows great potential as a cell-based therapy, although regulatory and technical challenges have so far limited their widespread use in Germany. An overview of current studies shows heterogeneous results regarding the choice of orthobiological agent and the timing of injections. While PRP and HA in combination with bone marrow stimulation procedures (BMS) such as microfracturing have already been intensively studied, there is still a lack of reliable data in combination with modern, cell-based procedures such as autologous chondrocyte transplantation (ACT). Systematic reviews and high-quality randomized controlled trials are urgently required to develop optimal treatment protocols to improve cartilage surgery. However, initial evidence suggests that orthobiologics may be an effective adjunct, particularly in controlling postoperative inflammation and promoting tissue regeneration.