P. Angele (Regensburg, DE)

University Hospital Regensburg Klinik für Unfallchirurgie, Traumatologie
Prof. Angele graduated summa cum laude at University of Ulm Medical School in 1994. In 2001; he finished his residency and graduated in Trauma Surgery and Orthopaedics at University of Regensburg; Germany. He attended an 18 months DFG-Postdoctoral fellowship in the Department of Orthopedics; Case Western Reserve University; Cleveland; Ohio; USA with the focus of stem cell differentiation; chondrogenesis. Peter joined the Department of Trauma and Reconstructive Surgery at the University Hospital Regensburg (Germany) in 2001 as a consultant of Orthopaedic and Traumatology and became Associate Professor in 2004. His received the venia legendi with the title “Meniscus reconstruction -Treatment options of Tissue Engineering” in 2004. He has been qualified to be a Full Professor in 2008. In 2010 he became a Professorship for Trauma Surgery with focus “Regenerative Joint Therapy” at the University Hospital Regensburg; Germany. Since 2010 he is director of „FIFA Medical Centre of Excellence – Regensburg“. His main research topic is the regeneration of cartilage and meniscus defects with biomaterial- and cell based approaches. Besides being a consultant for Regenerative Joint Therapy in the Department of Trauma and Reconstructive Surgery at the University Hospital Regensburg (Germany) he is since 2008 a consultant in the sporthopaedicum; a highly specialized clinical expert institution. His clinical practice consists of a broad-spectrum of sports medicine and trauma surgery with a predominant focus in the last 15 years on regenerative knee surgery.

Presenter Of 2 Presentations

Extended Abstract (for invited Faculty only) Chondrocytes

0.1 - Introduction: 21st Century Cartilage Regeneration in Germany

Presentation Topic
Chondrocytes
Date
12.04.2022
Lecture Time
10:00 - 10:15
Room
Potsdam 3
Session Type
Plenary Session

Abstract

Introduction

For 30 years several regenerative cartilage treatment procedures are in clinical use in Germany. Not all of them are available in other countries inside and outside Europe.

Content

According to guidelines from the working group “Clinical Tissue Regeneration” of the German Society of Orthopaedics and Trauma (DGOU) the selection of a distinct regenerative cartilage treatment procedure is dependent on cartilage defect size, the involvement of the subchondral plate and the underlying subchondral bone. Of course, further patient-specific parameters, like BMI, sport / work activities and patient expectations will further help to choose the most suitable regenerative cartilage treatment procedure for an individual patient. Also the necessity of treating the comorbidities (Leg axis deviation, instability, meniscus tear) has to be included in the treatment plan of the patients.

Microfracture is still the most frequently used technique for cartilage repair, also in Germany. In order to be successful with microfracture, one should use it only in small defects (<2cm2) or combine it with cell free biomaterials.

The indication of Osteochondral transplantation (OCT) has narrowed over the years. It is indicated for small, mainly osteochondral defects, which allow sufficient treatment with one or two osteochondral plugs. For larger defects, the donor-side morbidity is of concern.

Autologous chondrocyte implantation (ACI) is an established and well-accepted procedure for the treatment of localised full-thickness cartilage defects of the knee. This technique is available and widely used in Germany. Due to regulatory burdens in terms of harvest and culture of chondrocytes, the organizational effort of this technique is high. Therefore, this technique is mainly performed in center with specialization to cartilage treatment. In Germany, 3 different chondrocyte-based transplantation techniques are available (Novocart 3D (Aesculap, TETEC), Novocart inject (Aesculap, TETEC), Spherox (Codon). According to the German cartilage registry, which include over 10.000 patients, treated with regenerative cartilage procedures, the outcome of the 3 techniques is significant but comparable with each other. Based on best available scientific evidence, an indication for ACI is given for symptomatic cartilage defects, not only for traumatic but also for early-OA cartilage defects, starting from defect sizes of more than 2 cm2, while advanced degenerative joint disease needs to be considered as the most important contraindication.

Due to the limited access to osteochondral allografts, special sandwich techniques were developed in Germany to address bone and cartilage defects in huge osteochondral defects. The talk will describe recent developed techniques and show outcome results.

Unfortunately, recent advances in stem cell technology could not be translated in the clinic due to regulatory burdens in Germany. The use of these techniques in clinical trials would be of interest.

A newly developed cartilage repair procedure, minced cartilage technique, is used in Germany. The advantage is an one-step cartilage repair procedure without the regulatory burdens of the ACI technique. First results are promising, however, prospective outcome results are not available.

The rehabilitation after regenerative cartilage repair procedures is long. After ACI a return to sport is possible approximately after 1 year. Return to sport tests are used in Germany in order to analyze the neuromuscular ability for pivoting sports after 1year. The talk will show the need for these return to sport tests to avoid further reinjuries after rehabilitation.

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Extended Abstract (for invited Faculty only) Please select your topic

1.1.1 - Cartilage Repair - The Clinical Perspective

Presentation Topic
Please select your topic
Date
12.04.2022
Lecture Time
12:00 - 12:15
Room
Potsdam 1
Session Type
Special Session

Moderator Of 1 Session

Potsdam 3 Special Session
Session Type
Special Session
Date
12.04.2022
Time
14:30 - 15:30
Room
Potsdam 3
Session Description
This session focuses on the most updated clinical trial in the last years, impacting the treatment modalities or presenting innovative surgical modalities.
Session Learning Objective
  1. Clinical trials with the highest standard of scientific quality will help to understand new developments in the field of cartilage repair. Critical analysis according to EBM criteria will help to qualify those treatment options.
CME Evaluation