Abrasive arthroplasty

The removal of areas of chondromatous hyaline cartilage a nd the attempt to create new lod capacities for articular surfaces remain an encore in misce llaneous variations, pursued over decades in the last century. Recent resea rch findings describe the biochemical interrelations and the three-dimensio nal structures of the collagenic matrix much more exactly. It was not until now a better insight into the metabolism and the dependent "state of aggre gation" of the cartilage under changing mechanical exertion was made possib le. From it prove, that the hyaline cartilage of the articulations represen t a highly differentiated structure that is susceptible to mechanical and m etabolic nora and avails of remarkably minimal capability of regeneration. The results of repair are not within reach to approximate to functional abi lity of the original. This lights up that the amititious beginning to get t o qualitative comparable regeneration by repair is not completed yet. Previ ous and furthermore differentiated and with restrictions of chondrocytes in compound with other protective; and stimulating substances. Hitherto it se ems advisable to refrain from steps being too active therapeutically. The u nadulterated open abrasion of phathological articular cartilage has to be m arked obsolete, today. Also the effect of abrasive arthroplasty, inductive character suggested, remains in the opinion of well-known authors in no pro portion to expenditure of operation and rehabilitation and the expenses, be cause a sustaining success is not be expected in the long run, no matter wh ether drilling is done merely subcortical or subchondral, or use of spongio sa or microfracturing procedures. A more positive perspective in therapy ap pears with the holmium YAG-laser paving the way for gently treatment merely for degenerated cartilage: Regenerative beginnings to build hyaline cartil age have been reoprted. The abrasive arthroplasty propably will establish a s a joint-conserving prodecure in combination with the possability of trans plantation of chondrocyxtes to improve specific construction of the collage n matrix.