You extensively researched cartilage repair throughout your surgical career. You specialize in the minimally invasive surgical treatment of knee injuries, especially in sports and in professional athletes. How do you see the future of knee injury treatment and knee osteoarthritis therapy? What will be possible in knee cartilage repair in the future? Yes. I think this is a big, big, big topic – how to avoid using artificial joints. So, I use in my practice no artificial joints. So, no endoprosthesis. I deal with arthritic joints with the limitation of function. I understand, and I realize that there is a fine balance in osteoarthritic joints between a latent and active osteoarthritic process. There are many different things to consider. If you could control the inflammation in the joint with good biomechanical treatment, then many patients have success, a good function in a joint. These patients can do without an artificial joint. So, I see in my patients that they are trying to avoid artificial joints for their problems. So, the main problem, the main focus of treatment, is to control the osteoarthritic process and to bring the joint back into balance. In the future, we will see more use of stem cells. We have two focal points of joint injury therapy. One is how you can restore a big area of damaged cartilage in the joint. The second point is how you can control the inflammation and the arthritic process in the joint. Because to restore cartilage, there needs to be a low inflammation in the joint. Otherwise, you will not have success with joint injury treatment. In the osteoarthritic joints treatment field, we will see more 3D-manufactured approaches, with the use of 3D printers. There are some research projects which are starting to restore huge areas of damaged cartilage by using a tissue engineering approach [to transfer cartilage] from other joint areas. The other field parallel to cartilage repair is the allograft cartilage transplantation techniques. They are used more often now. Cartilage allograft treatments allowed many different benefits. So, I also use pieces of cartilage from allograft in the situations where I have to restore a joint cartilage area which is completely damaged by osteoarthritic inflammation. So, allograft pieces of cartilage allowed us to restore a joint surface from complete damage to a healthy cartilage structure. [In allograft cartilage transplantation] you do not have to wait for the cartilage tissue to grow. The cartilage tissue is already in place. You only has to address its re-fixation on the bone. So, the other point is the different treatments that use stem cells. But we have to recognize that stem cells are signaling cells that are transporting information for cartilage regeneration. Stem cells themselves only transports the information. Although stem cells don’t do the big job of actual regeneration of cartilage tissue. In the majority of cases, stem cells are used to enhance the regeneration potential in the joints. But there are strict limitations for the use of stem cells. There is no single [joint trauma or injury treatment] technique that will cover the problem. But various treatment techniques allow us to go more to the margins, to the edge of the severity of the osteoarthritic process in the patient. So we can control the joint injury situation and allow a good life quality for that patient.
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