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  • Tolgay Şatana

Cartilage Regeneration Therapy


Cartilage Regeneration Therapy; Since cartilage tissue has limited ability to regenerate itself, when it disappears with aging, they leave their places to cells that cannot function as cartilage cells, which we call fibrocytes.

However, the cartilage cell that forms the cartilage structure is "Chondrocyte". Its task is to provide lubricity and smooth the joint surface. For this function, the cell mechanically settles in the collagen connective tissue called matrix in chambers called lacunae.

Its chemical task is to produce the continuously renewable matrix in which it is contained, thus ensuring the production of collagen, and most importantly, to produce substances that regulate fluid dynamics by exchanging with joint fluid.

In this respect, cartilage is the basic cells of the joint structure.

From this point of view, if the cartilage damage is a loss at the matrix level, that is, if the cartilage cell protected in the lacunae is not damaged by a simple crush, the cartilage replaces the damaged matrix immediately and makes a new one, and the cartilage is overcome without loss. If the cell loss is at the millimeter level and less, those regions are covered with a matrix even if new cells do not form. Other cells can develop to take over the functions of the lost cells.

If the cartilage loss to be searched is over 1mm, there is no repair with the matrix and fibrocytes come to the area and make the repair, but the cartilage structure formed is "fibrous" and does not produce matrix like cartilage tissue and causes an irregular formation in that area as a non-slippery structure in regeneration. This is not a preferred healing way as it causes abrasion on the opposite surface.

Here, the healing form created by the "enriched plasma" cells that we call PRP provides such a cartilage repair and only slows down the erosion.

The only way to repair cartilage with cartilage cells is to bring cartilage cells to the area. We call this cartilage transplantation. If we transfer our own cell, "autologous" cells of another human being, "allo" is called "Xenograft" if we take it from another species (cattle, etc.). Since applying allo and xenografts at the cellular level requires risks such as tissue rejection or long regeneration time, we only use antigen-removed crystals at the matrix level. These can be given as an example of hyaluronic acid injected into the joint. These items are for supporting the matrix. It is called (viscosupplementation).

"Autologous chondrocyte transplantation", which is used in the treatment of cartilage damage especially in the joint areas, is a safe, biological and effective method.

Cartilage Regeneration Therapy

Autologous Chondrocyte does not necessarily require cartilage cells, but it is the easiest and ethical method of obtaining permissions. Therefore, the cartilage cells of the patient must be surgically removed by arthroscopic method. Cartilage cells are taken and extracted from Lakuna in the laboratory and the ability to multiply is gained. Within a week, thousands of cells can be produced and ready for transfer. The material obtained in this method is cartilage cell culture and not cartilage.

In some laboratories, these cells can be frozen and stored. For example, the cartilages produced in specialized GPS centers such as the FloenCell laboratory are delivered to the operating room in this way.

In the meantime, the production of personalized chondrocytes is continued. The newly obtained chondrocyte cells are frozen and stored in liquid nitrogen tanks at -196 ° C to be used as the 2nd and 3rd dose when desired.

Cellular products taken out from FlorenCell Laboratories to be applied to the patient are delivered to the patient to the place of application within 24 hours at the latest in transport boxes that can be monitored with a GPS module and a software.

We use chondrocyte usage areas to close cartilage defects. Since the defects do not consist of cells only, a matrix is ​​needed and a barrier to prevent the cells from mixing with the joint fluid is essential. If the cartilage prepared in the laboratory is not embedded in such a matrix (composite cartilage graft), we place it on the cartilage defect with open joint surgery and close it with a collagen membrane.

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