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<p>The minced cartilage procedure is a&#xa0;method for treating focal cartilage defects, in which cartilage from the defect area or from other locations within the joint is fragmented, processed using orthobiological techniques, and then applied in a&#xa0;single-stage procedure to cover the defect. A&#xa0;specific application of this method is the Autocart™ technique (Arthrex, Naples, FL, USA), which will be presented in this article. The surgery is performed with the patient in a&#xa0;supine position in a&#xa0;standardized aseptic setting. First, an arthroscopic assessment of the joint structures is carried out, including documentation and preparation of the defect (images, measurements). Once the indication is confirmed (medium-grade focal cartilage defect, International Cartilage Repair Society [ICRS] III–IV), the defect is prepared (edge stabilization and debridement), and an arthroscopic cartilage biopsy is taken using a&#xa0;motorized shaver. The cartilage fragments are collected in a&#xa0;special container, the GraftNet™ (Arthrex). In parallel or beforehand, approximately 15 ml of the patient’s autologous blood is collected to prepare platelet-rich plasma (ACP™, Arthrex) using a&#xa0;specialized centrifuge. Next, the minced cartilage is mixed in a&#xa0;bowl with 2–3 drops of ACP until a&#xa0;moldable substance (a&#xa0;paste of cartilage chips) is formed. Then, using the remaining ACP, autologous thrombin is prepared in a&#xa0;special device (Thrombinator™, Arthrex). In the following step, thrombin previously extracted from the Thrombinator™ is gradually dripped onto the cartilage paste. The entire mass is then distributed into the defect either arthroscopically or via an open approach using an applicator, achieving approximately 80% defect filling. The consistency of the paste provides initial stability, as the thrombin in combination with ACP activates fibrin, which stabilizes and fixes the paste within the defect. Additional fibrin is produced by mixing the remaining thrombin and ACP in a&#xa0;1:1 ratio and is used to seal the implanted cartilage graft. Postoperatively, partial weight-bearing is recommended for 6&#xa0;weeks, with free passive range of motion.</p>

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Das „Minced-cartilage-Verfahren“ zur Therapie lokaler Knorpelschäden am Kniegelenk

  • 期刊论文

  • 发表日期：

    2025年11月28日

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  • Wolf Petersen,
  • Julia Ohde,
  • Maurice Balke,
  • Lukas Eckhard,
  • Phillip P. Roessler

摘要

The minced cartilage procedure is a method for treating focal cartilage defects, in which cartilage from the defect area or from other locations within the joint is fragmented, processed using orthobiological techniques, and then applied in a single-stage procedure to cover the defect. A specific application of this method is the Autocart™ technique (Arthrex, Naples, FL, USA), which will be presented in this article. The surgery is performed with the patient in a supine position in a standardized aseptic setting. First, an arthroscopic assessment of the joint structures is carried out, including documentation and preparation of the defect (images, measurements). Once the indication is confirmed (medium-grade focal cartilage defect, International Cartilage Repair Society [ICRS] III–IV), the defect is prepared (edge stabilization and debridement), and an arthroscopic cartilage biopsy is taken using a motorized shaver. The cartilage fragments are collected in a special container, the GraftNet™ (Arthrex). In parallel or beforehand, approximately 15 ml of the patient’s autologous blood is collected to prepare platelet-rich plasma (ACP™, Arthrex) using a specialized centrifuge. Next, the minced cartilage is mixed in a bowl with 2–3 drops of ACP until a moldable substance (a paste of cartilage chips) is formed. Then, using the remaining ACP, autologous thrombin is prepared in a special device (Thrombinator™, Arthrex). In the following step, thrombin previously extracted from the Thrombinator™ is gradually dripped onto the cartilage paste. The entire mass is then distributed into the defect either arthroscopically or via an open approach using an applicator, achieving approximately 80% defect filling. The consistency of the paste provides initial stability, as the thrombin in combination with ACP activates fibrin, which stabilizes and fixes the paste within the defect. Additional fibrin is produced by mixing the remaining thrombin and ACP in a 1:1 ratio and is used to seal the implanted cartilage graft. Postoperatively, partial weight-bearing is recommended for 6 weeks, with free passive range of motion.