It has long been thought that damaged cartilage and bone tissues could not be regenerated, but thanks to advances in research that have disproved this belief, many international research strands have opened up that aim at biological joint reconstruction.

Professor Maurilio Marcacci, Head of the Centre for Knee Joint Reconstruction at Humanitas, and Professor Elizaveta Kon, specialist at the Centre and Head of the Translational Orthopedics Section, spoke on the subject in a service by Tg2 Medicina 33.

“This is because cartilage has been shown to have a certain capacity to regenerate, especially if the reasons for the damage have been corrected. The use of materials that reconstruct cartilage and bone helps cartilage in this regeneration,” explains Prof. Marcacci.


Using the scaffolds

The treatment can include the use of scaffolds, special support structures made of cutting-edge biomaterials: “These are clinical studies of effectiveness, in which we compare new biomaterials to more traditional techniques considered routine. The aim of the studies is to demonstrate that new techniques are more scientifically valid than those already established in clinical practice.

The area of the knee that has experienced degeneration is identified, and during surgery, the scaffold is placed inside the joint in place of the damaged bone and cartilage. The cells then come from the patient’s bone marrow, enter the scaffold and recreate the bone and cartilage. The scaffold should disappear within a year, as it is bioactive and completely absorbable,” says Professor Kon.


In what cases do you prefer joint reconstruction to prosthesis?

“We tend to try to intervene on joint reconstruction in young patients, with high functional demands and a future ahead,” says the professor.

“The indication is based on the severity of the disease – adds Prof. Marcacci. A very serious illness in a young patient requires the use of joint prostheses. A patient of modest severity, even at a certain age, can be treated conservatively. It is then difficult to think of reconstructing cartilage if the reason for its occurrence has not been identified before: an accurate diagnosis is therefore fundamental”.


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