Defect area
Spherox application
4 months after Spherox transplant
Microfracturing (nanoFX®)
- Suitable for smaller defects up to 2 cm²
- Mobilizes stem cells from bone marrow to promote cartilage regeneration
HyaloFast®
- Suitable for defect sizes of 1 to 4.5 cm²
- Serves as a framework for stem cells and supports healing
Autologous Chondrocyte Transplantation (Spherox)
- Suitable for defect sizes from 2 cm² to 10 cm²
- Involves the removal and cultivation of the patient's own cartilage cells, which are then transplanted
Biopsy
Extraction of small cylinders of healthy cartilage from the affected joint and, in addition, a blood sample for cell cultivation
Cultivation
Isolation and multiplication of cartilage cells with addition of patient blood serum to spheroids
Transplantation
Introduction of spheroids into the cartilage defect in a second minimally invasive procedure. The spheroids stick independently and form new cartilage tissue, which connects to the existing healthy cartilage.
Rehabilitation
An individually adapted rehabilitation plan starts after the transplant and gradually increases the load on the joint up to full resilience
Dr. Wolfgang Zinser about cell therapy & Spherox
Rehabilitation phases after a Spherox transplant
proliferation phase
Growth of new cartilage cells in the cartilage defect
During the first few weeks, severe shear forces on the young regenerated material should be avoided at all costs. However, it is necessary to move the joint to nourish the growing cartilage cells, so the following examples of treatment methods are recommended:
- Gradually increasing the range of motion with knee joint orthosis
- Passive movement training with CPM splint, 2 x approx. 30 min/day for 6 weeks
- Controlled physiotherapy with movement exercises
Transformation phase
Development of cartilage cells and the formation of type II collagen
Proteoglycans form the cartilage matrix, which is important for the formation of cartilage. The regenerated material now has a sponge-like consistency and is becoming increasingly solid. If the healing process is normal, extensive filling of the cartilage defect can be seen after 3 months. Examples of treatment methods in this phase:
- Restoring full passive and active range of motion through physiotherapy
- Gradual increase in stress in the 7th - 8th postoperative week up to full load from the 9th postoperative week
- Endurance training through stationary cycling (from 8 weeks), crawl swimming and aqua jogging (from 10 weeks)
remodeling phase
Increasing strengthening of regenerated cartilage with the formation of protein networks
The transplant now forms a firm connection to the bone and surrounding cartilage line. In this phase, the focus is on muscle training, as well as endurance training, functional and coordination training.
Examples of treatment methods include:
- Continuation of endurance training with cycling, swimming, aqua jogging, rowing ergometer, stepper, cross trainer, Nordic walking
- Easy equipment training with a high number of repetitions under physiotherapeutic guidance
Maturation phase
Large matrix proteins increasingly stabilize regenerated cartilage and form a framework for cartilage cells
The connection to the subchondral bone and the surrounding cartilage is strengthened. Even after the 2nd and 3rd postoperative year, there is still a further improvement in cartilage quality. Examples of advanced treatment methods:
- Muscle-building training on equipment (dosed, emphasis on the number of repetitions, no load peaks)
- Cycling, swimming, aqua jogging, rowing ergometer, stepper, cross trainer, Nordic walking, cross-country skiing
- Jogging on the level from 9 to 12 months depending on the original size of the defect
Spherox studies
