{"id":{"repo_id":"aachen","oai_identifier":"oai:publications.rwth-aachen.de:62120"},"canonical_url":"https://search.dev.ndltd.org/etd/aachen/oai:publications.rwth-aachen.de:62120","repository":{"repo_id":"aachen","name":"RWTH Aachen University","base_url":"https://publications.rwth-aachen.de/oai2d"},"display":{"title":"Bestimmung osteochondraler Marker in der Gelenkflüssigkeit zur Verlaufskontrolle unterschiedlicher operativer Knorpelbehandlungstechniken","abstract":"With the help of molecular markers it has become possible to quantify cartilage and bone degradation in joints. This is the first study that attempts to assess current surgical techniques for cartilage treatment comparatively by quantification of molecular markers in the synovia. Patients who underwent Autologous Chondrocyte Implantation (ACI), Osteochondral Autologous Transplantation (OAT) and Microfracturing (MF) were followed up. At the same time it was assessed if the different markers could be used for the documentation of postoperative healing. In this prospective study 17 ACI-patients, 6 OAT-patients and 9 MF-patients were examined both preoperatively and 6, 12, 26 and 52 weeks after the operative interventions. The knee joints were washed out with 50 ml of normal saline and the parameters metalloproteinase 1 (MMP-I), metalloproteinase 3 (MMP-3), tissue inhibitor of metalloproteinase 1 (TIMP-1), YKL-40 (chondrex), protoglycan (PG), deoxypyridinolin (DPD), n-telopeptide (NTx) from type I collagen and c-terminal propeptide from type I collagen (PICP) were quantified by commercial ELISA-kits. The measured levels were referenced to the total protein concentration of the synovial lavage fluid. In addition to the molecular analysis of these markers, clinical and magnetic resonance examinations were carried out. The tendencies over time (baseline related) and the total protein-referenced concentrations of the markers MMP-1 , MMP-3, TIMP-1, YKL-40, NTx and PICP after one year, confirmed their ability to assess osteochondral healing and reflected a favourable influence of ACI on the joint-milieu. The concentrations of the markers dropped off and came close to physiological levels. In contrast to this, the course of markers in OAT revealed a traumatising influence of this surgical method with a poor metabolic status at the end of the follow-up interval. This was clearly shown by the markers YKL-40 and NTx, which were found to be above the baseline after one year, whereas in ACI markedly below. Additionally the total protein-referenced levels of YKL-40 and NTx were strongly elevated in OAT compared to ACI and MF by showing good comparability (equal protein-concentrations after one year). In OAT compared to ACI and MF, PICP showed this tendency as well by falling only slightly below the baseline-level. These results were supported by magnetic resonance imaging findings, which showed good defect-filling in 82% of the cases in ACI. In OAT incomplete defect-healing was found at not less than one donor-site in all patients and the others donor-sites were demarcated. The area of the defect showed good transplantation results in 50%, poor results in 33% and unsatisfactory results in 17% of the patients. The influence of Microfracturing on the molecular markers were inconclusive since this patient-group had poor preoperative conditions and were not comparable to the patient-groups of ACI and OAT. Facing impossible randomisation and a low number of patients, this study can only be considered as a pilot study with limited conclusions. Further studies with higher numbers of patients have to follow to confirm the different tendencies comparing the surgical methods. Molecular markers provide a new diagnostic approach to the evaluation of surgical treatment of cartilage, however there is no ideal, absolute specific marker of cartilage. Therefore more research is necessary for further progression of an objective assessment of operative techniques to repair cartilage.","abstract_html":"With the help of molecular markers it has become possible to quantify cartilage and bone degradation in joints. This is the first study that attempts to assess current surgical techniques for cartilage treatment comparatively by quantification of molecular markers in the synovia. Patients who underwent Autologous Chondrocyte Implantation (ACI), Osteochondral Autologous Transplantation (OAT) and Microfracturing (MF) were followed up. At the same time it was assessed if the different markers could be used for the documentation of postoperative healing. In this prospective study 17 ACI-patients, 6 OAT-patients and 9 MF-patients were examined both preoperatively and 6, 12, 26 and 52 weeks after the operative interventions. The knee joints were washed out with 50 ml of normal saline and the parameters metalloproteinase 1 (MMP-I), metalloproteinase 3 (MMP-3), tissue inhibitor of metalloproteinase 1 (TIMP-1), YKL-40 (chondrex), protoglycan (PG), deoxypyridinolin (DPD), n-telopeptide (NTx) from type I collagen and c-terminal propeptide from type I collagen (PICP) were quantified by commercial ELISA-kits. The measured levels were referenced to the total protein concentration of the synovial lavage fluid. In addition to the molecular analysis of these markers, clinical and magnetic resonance examinations were carried out. The tendencies over time (baseline related) and the total protein-referenced concentrations of the markers MMP-1 , MMP-3, TIMP-1, YKL-40, NTx and PICP after one year, confirmed their ability to assess osteochondral healing and reflected a favourable influence of ACI on the joint-milieu. The concentrations of the markers dropped off and came close to physiological levels. In contrast to this, the course of markers in OAT revealed a traumatising influence of this surgical method with a poor metabolic status at the end of the follow-up interval. This was clearly shown by the markers YKL-40 and NTx, which were found to be above the baseline after one year, whereas in ACI markedly below. Additionally the total protein-referenced levels of YKL-40 and NTx were strongly elevated in OAT compared to ACI and MF by showing good comparability (equal protein-concentrations after one year). In OAT compared to ACI and MF, PICP showed this tendency as well by falling only slightly below the baseline-level. These results were supported by magnetic resonance imaging findings, which showed good defect-filling in 82% of the cases in ACI. In OAT incomplete defect-healing was found at not less than one donor-site in all patients and the others donor-sites were demarcated. The area of the defect showed good transplantation results in 50%, poor results in 33% and unsatisfactory results in 17% of the patients. The influence of Microfracturing on the molecular markers were inconclusive since this patient-group had poor preoperative conditions and were not comparable to the patient-groups of ACI and OAT. Facing impossible randomisation and a low number of patients, this study can only be considered as a pilot study with limited conclusions. Further studies with higher numbers of patients have to follow to confirm the different tendencies comparing the surgical methods. Molecular markers provide a new diagnostic approach to the evaluation of surgical treatment of cartilage, however there is no ideal, absolute specific marker of cartilage. Therefore more research is necessary for further progression of an objective assessment of operative techniques to repair cartilage.","abstract_has_math":false,"creators":["Bauer, Stefan Hermann"],"institution":"Publikationsserver der RWTH Aachen University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Schneider, Ulrich Jürgen"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2005,"date_issued":"2005","date_published":"2005","updated_at":"2026-07-30T19:43:19Z","subjects":["info:eu-repo/classification/ddc/610","Medizin","Autologe Chondrozyten Transplantation","Osteochondrale Autologe Transplantation","Mosaikplastik","Mikrofrakturierung","Chondrozyten","Synovia"],"languages":["ger"],"rights":["info:eu-repo/semantics/openAccess"],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-123713%22"],"render_values":[{"text":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-123713%22","href":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-123713%22","code":true}]}]},"links":{"outbound_url":"https://publications.rwth-aachen.de/record/62120","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Schneider, Ulrich Jürgen"]},{"key":"dc:creator","label":"Author","values":["Bauer, Stefan Hermann"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:coverage","label":"Dc Coverage","values":["DE"]},{"key":"dc:date","label":"Dc Date","values":["2005"]},{"key":"dc:publisher","label":"Institution","values":["Publikationsserver der RWTH Aachen University"]},{"key":"dc:relation","label":"Dc Relation","values":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-11462"]},{"key":"dc:type","label":"Dc Type","values":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["info:eu-repo/classification/ddc/610","Medizin","Autologe Chondrozyten Transplantation","Osteochondrale Autologe Transplantation","Mosaikplastik","Mikrofrakturierung","Chondrozyten","Synovia"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["ger"]},{"key":"dc:rights","label":"Dc Rights","values":["info:eu-repo/semantics/openAccess"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/record/62120","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-123713%22"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["With the help of molecular markers it has become possible to quantify cartilage and bone degradation in joints. This is the first study that attempts to assess current surgical techniques for cartilage treatment comparatively by quantification of molecular markers in the synovia. Patients who underwent Autologous Chondrocyte Implantation (ACI), Osteochondral Autologous Transplantation (OAT) and Microfracturing (MF) were followed up. At the same time it was assessed if the different markers could be used for the documentation of postoperative healing. In this prospective study 17 ACI-patients, 6 OAT-patients and 9 MF-patients were examined both preoperatively and 6, 12, 26 and 52 weeks after the operative interventions. The knee joints were washed out with 50 ml of normal saline and the parameters metalloproteinase 1 (MMP-I), metalloproteinase 3 (MMP-3), tissue inhibitor of metalloproteinase 1 (TIMP-1), YKL-40 (chondrex), protoglycan (PG), deoxypyridinolin (DPD), n-telopeptide (NTx) from type I collagen and c-terminal propeptide from type I collagen (PICP) were quantified by commercial ELISA-kits. The measured levels were referenced to the total protein concentration of the synovial lavage fluid. In addition to the molecular analysis of these markers, clinical and magnetic resonance examinations were carried out. The tendencies over time (baseline related) and the total protein-referenced concentrations of the markers MMP-1 , MMP-3, TIMP-1, YKL-40, NTx and PICP after one year, confirmed their ability to assess osteochondral healing and reflected a favourable influence of ACI on the joint-milieu. The concentrations of the markers dropped off and came close to physiological levels. In contrast to this, the course of markers in OAT revealed a traumatising influence of this surgical method with a poor metabolic status at the end of the follow-up interval. This was clearly shown by the markers YKL-40 and NTx, which were found to be above the baseline after one year, whereas in ACI markedly below. Additionally the total protein-referenced levels of YKL-40 and NTx were strongly elevated in OAT compared to ACI and MF by showing good comparability (equal protein-concentrations after one year). In OAT compared to ACI and MF, PICP showed this tendency as well by falling only slightly below the baseline-level. These results were supported by magnetic resonance imaging findings, which showed good defect-filling in 82% of the cases in ACI. In OAT incomplete defect-healing was found at not less than one donor-site in all patients and the others donor-sites were demarcated. The area of the defect showed good transplantation results in 50%, poor results in 33% and unsatisfactory results in 17% of the patients. The influence of Microfracturing on the molecular markers were inconclusive since this patient-group had poor preoperative conditions and were not comparable to the patient-groups of ACI and OAT. Facing impossible randomisation and a low number of patients, this study can only be considered as a pilot study with limited conclusions. Further studies with higher numbers of patients have to follow to confirm the different tendencies comparing the surgical methods. Molecular markers provide a new diagnostic approach to the evaluation of surgical treatment of cartilage, however there is no ideal, absolute specific marker of cartilage. Therefore more research is necessary for further progression of an objective assessment of operative techniques to repair cartilage."]},{"key":"dc:source","label":"Dc Source","values":["Aachen : Publikationsserver der RWTH Aachen University 98 S. : Ill., graph. Darst. (2005). = Aachen, Techn. Hochsch., Diss., 2005"]},{"key":"dc:title","label":"Title","values":["Bestimmung osteochondraler Marker in der Gelenkflüssigkeit zur Verlaufskontrolle unterschiedlicher operativer Knorpelbehandlungstechniken"]}]}],"canonical_facts":{"dc:contributor":["Schneider, Ulrich Jürgen"],"dc:coverage":["DE"],"dc:creator":["Bauer, Stefan Hermann"],"dc:date":["2005"],"dc:description":["With the help of molecular markers it has become possible to quantify cartilage and bone degradation in joints. This is the first study that attempts to assess current surgical techniques for cartilage treatment comparatively by quantification of molecular markers in the synovia. Patients who underwent Autologous Chondrocyte Implantation (ACI), Osteochondral Autologous Transplantation (OAT) and Microfracturing (MF) were followed up. At the same time it was assessed if the different markers could be used for the documentation of postoperative healing. In this prospective study 17 ACI-patients, 6 OAT-patients and 9 MF-patients were examined both preoperatively and 6, 12, 26 and 52 weeks after the operative interventions. The knee joints were washed out with 50 ml of normal saline and the parameters metalloproteinase 1 (MMP-I), metalloproteinase 3 (MMP-3), tissue inhibitor of metalloproteinase 1 (TIMP-1), YKL-40 (chondrex), protoglycan (PG), deoxypyridinolin (DPD), n-telopeptide (NTx) from type I collagen and c-terminal propeptide from type I collagen (PICP) were quantified by commercial ELISA-kits. The measured levels were referenced to the total protein concentration of the synovial lavage fluid. In addition to the molecular analysis of these markers, clinical and magnetic resonance examinations were carried out. The tendencies over time (baseline related) and the total protein-referenced concentrations of the markers MMP-1 , MMP-3, TIMP-1, YKL-40, NTx and PICP after one year, confirmed their ability to assess osteochondral healing and reflected a favourable influence of ACI on the joint-milieu. The concentrations of the markers dropped off and came close to physiological levels. In contrast to this, the course of markers in OAT revealed a traumatising influence of this surgical method with a poor metabolic status at the end of the follow-up interval. This was clearly shown by the markers YKL-40 and NTx, which were found to be above the baseline after one year, whereas in ACI markedly below. Additionally the total protein-referenced levels of YKL-40 and NTx were strongly elevated in OAT compared to ACI and MF by showing good comparability (equal protein-concentrations after one year). In OAT compared to ACI and MF, PICP showed this tendency as well by falling only slightly below the baseline-level. These results were supported by magnetic resonance imaging findings, which showed good defect-filling in 82% of the cases in ACI. In OAT incomplete defect-healing was found at not less than one donor-site in all patients and the others donor-sites were demarcated. The area of the defect showed good transplantation results in 50%, poor results in 33% and unsatisfactory results in 17% of the patients. The influence of Microfracturing on the molecular markers were inconclusive since this patient-group had poor preoperative conditions and were not comparable to the patient-groups of ACI and OAT. Facing impossible randomisation and a low number of patients, this study can only be considered as a pilot study with limited conclusions. Further studies with higher numbers of patients have to follow to confirm the different tendencies comparing the surgical methods. Molecular markers provide a new diagnostic approach to the evaluation of surgical treatment of cartilage, however there is no ideal, absolute specific marker of cartilage. Therefore more research is necessary for further progression of an objective assessment of operative techniques to repair cartilage."],"dc:identifier":["https://publications.rwth-aachen.de/record/62120","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-123713%22"],"dc:language":["ger"],"dc:publisher":["Publikationsserver der RWTH Aachen University"],"dc:relation":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-11462"],"dc:rights":["info:eu-repo/semantics/openAccess"],"dc:source":["Aachen : Publikationsserver der RWTH Aachen University 98 S. : Ill., graph. Darst. (2005). = Aachen, Techn. Hochsch., Diss., 2005"],"dc:subject":["info:eu-repo/classification/ddc/610","Medizin","Autologe Chondrozyten Transplantation","Osteochondrale Autologe Transplantation","Mosaikplastik","Mikrofrakturierung","Chondrozyten","Synovia"],"dc:title":["Bestimmung osteochondraler Marker in der Gelenkflüssigkeit zur Verlaufskontrolle unterschiedlicher operativer Knorpelbehandlungstechniken"],"dc:type":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]},"updated_at":"2026-07-30T19:43:19Z"}