Peter Behrens

Peter Behrens
Orthodok Hamburg, Germany

Prof. Dr. med.

About

102
Publications
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3,435
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Publications

Publications (102)
Article
Full-text available
Background The patellofemoral joint is a challenging environment for treating chondral defects. Among the surgical options for the treatment of chondral defects, the single-stage Autologous Matrix-Induced Chondrogenesis (AMIC) procedure uses a porcine collagen I/III membrane to enhance bone-marrow stimulation. However, longer term outcomes data are...
Article
Full-text available
Methods: Peer-reviewed literature was analyzed regarding different topics relevant to osteochondral lesions of the talus (OLTs) treatment. This process concluded with a statement for each topic reflecting the best scientific evidence available for a particular diagnostic or therapeutic concept, including the grade of recommendation. Besides the sc...
Preprint
Full-text available
Background The patellofemoral joint is a challenging environment for treating chondral defects. Among the surgical options for the treatment of chondral defects, the single-stage AMIC procedure uses a collagen I/III membrane to enhance bone-marrow stimulation. However, longer term outcomes data are rare for this specific indication. In order to pro...
Article
Zusammenfassung Die Arbeitsgemeinschaft „Klinische Geweberegeneration“ hat bereits in den Jahren 2004, 2013 und 2016 Empfehlungen in Bezug auf die Indikation für verschiedene knorpelregenerative Verfahren zur Behandlung von Knorpelschäden am Kniegelenk publiziert. Auf Basis neuer wissenschaftlicher Erkenntnisse sollen in der vorliegenden Arbeit die...
Article
Full-text available
Purpose To evaluate the clinical outcomes of patients with a minimum 2-year follow-up following contemporary patellofemoral inlay arthroplasty (PFIA) and to identify potential risk factors for failure in a multi-center study. Methods All patients who underwent implantation of PFIA between 09/2009 and 11/2016 at 11 specialized orthopedic referral c...
Article
Full-text available
Introduction: We present the first retrospective study that compares two various autologous matrix-induced chondrogenesis (AMIC) surgical interventions to repair grade III-IV cartilage defects in the knee. Patients who underwent minimally invasive (arthroscopy) or open (mini-arthrotomy) AMIC were followed up to 2 years to investigate if minimally...
Article
Zusammenfassung Hintergrund Bei fokalen teilschichtigen Knorpelläsionen (Grad II – III) besteht im klinischen Alltag oft noch Unsicherheit hinsichtlich des zu empfehlenden therapeutischen Vorgehens. Während bei großflächigen, arthrotischen Knorpelveränderungen das Débridement gemäß der gängigen Lehrmeinung weitgehend abzulehnen ist, so steht eine E...
Article
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Introduction: A prospective clinical investigation was carried out in order to clarify whether Matrix-associated autologous chondrocyte implantation (MACI) results in clinical improvement at long-term follow-up. Hypothesis: MACI will result in clinical improvement at long-term follow-up. Study design: Case series; level of evidence, 4. Method...
Article
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The limited intrinsic healing potential of human articular cartilage is a well-known problem in orthopedic surgery. Thus a variety of surgical techniques have been developed to reduce joint pain, improve joint function and delay the onset of osteoarthritis. Microfractures as a bone marrow stimulation technique present the most common applied articu...
Article
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2 2 2 2 2 1 2 Sydney/AU MeSH: Cartilage, Articular [A02.835.583.192] Arthroscopy [E04.555.113] Cartilage Diseases [C05.182]
Article
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The potential of subchondral mesenchymal stem cell stimulation (MSS) for cartilage repair has led to the widespread use of microfracture as a first line treatment for full thickness articular cartilage defects. Recent focus on the effects of subchondral bone during cartilage injury and repair has expanded the understanding of the strengths and limi...
Article
Full-text available
The regeneration capacity of articular cartilage is very limited. Therefore, cartilage defects heal poorly and are known as prearthrotic lesions. Autologous Matrix-Induced Chondrogenesis (AMIC) is an innovative treatment concept for localized full-thickness cartilage defects. This technique combines the well-established microfracturing with a colla...
Article
Full-text available
Auch wenn sich die Evidenzlage in Bezug auf die verfügbaren Studien zur operativen Behandlung von Knorpelschäden in den letzten Jahren deutlich gebessert hat, besteht noch immer kein einheitlicher Konsens bezüglich der optimalen Therapie des lokalisierten Knorpeldefektes. Im Vergleich zur zweizeitigen Knorpeldefektbehandlung weisen einzeitige Thera...
Article
Full-text available
Autologous chondrocyte transplantation/implantation (ACT/ACI) is an established and recognised procedure for the treatment of localised full-thickness cartilage defects of the knee. The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Traumatology (DGOU) describes the biology and function...
Article
Full-text available
Introduction: Autologous Matrix-Induced Chondrogenesis (AMIC) is an innovative treatment for localized full-thickness cartilage defects combining the well-known microfracturing with collagen I/III scaffold. The purpose of this analysis was to evaluate the medium-term results of this enhanced microfracture technique for the treatment of chondral le...
Article
Full-text available
Articular resurfacing by treatment of chondral defects may include chondral abrasion, autologous chondrocyte Implantation (ACI), matrix-induced chondrocyte transplantation (MACT) or osteochondral autologous transplantation (OATS). This technical note describes the method of autologous matrix-induced chondrogenesis (AMIC), a one-step procedure combi...
Article
Articular cartilage defects heal poorly. Autologous Matrix-Induced Chondrogenesis (AMIC) is an innovative treatment for localized full-thickness cartilage defects combining the well-known microfracturing with collagen scaffold and fibrin glue. The purpose of this prospective study was to evaluate the medium-term results of this enhanced microfractu...
Article
The aim of this study was to perform a systematic review of studies concerning current treatment of chondral defects of the knee. The relevance for evidence based data and for successful surgical treatment of cartilage defects was evaluated. From 56,098 evaluated studies, 133 studies could be further pursued. These supplied data concerning microfra...
Article
Full-text available
The objective of this technical note is to describe the autologous matrix induced chondrogenesis (AMIC) procedure and to evaluate its possible role for resurfacing of retropatellar cartilage defects. AMIC is a one-step procedure combining microfracturing with application of a collagen I/III membrane to protect the initial blood clot and to serve as...
Article
Full-text available
The aim of this study was to evaluate the regenerative potential of cell-laden and cell-free collagen matrices in comparison to microfracture treatment applied to full-thickness chondral defects in an ovine model. Animals (n = 30) were randomized into 5 treatment groups, and 7-mm full-cartilage-thickness defects were set at the trochlea and medial...
Article
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Options for the treatment of cartilage defects include chondral resurfacing with abrasion, debridement, autologous chondrocyte transplantation (ACT), matrix-induced chondrocyte transplantation (MACI), or osteochondral autologous transplantation (OATS). This article describes the new method of autologous matrix-induced chondrogenesis (AMIC), a 1-ste...
Chapter
Knochenverluste können sowohl mit auto- oder allogenem Knochen aufgefüllt werden, wie auch mit einem nicht vaskularisierten, freien, kortikospongiösen Span behandelt werden. Langstreckige Substanzverluste können mit mikrovaskulär angeschlossenen, autogenen oder allogenen, vaskularisierten Transplantaten überbrückt werden. Segmentale Unterbrechungen...
Article
Full-text available
Repair of localized cartilage defects in the knee. Localized partial or full-thickness cartilage defects in the knee or osteochondral lesions (osteochondritis dissecans [OD]). Generalized cartilage defects, osteoarthritis, bacterial and rheumatoid arthritis, uncorrected axis deformities, ligament instability, patella instability, meniscectomy. Two-...
Article
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Between 1995 and 2003, 41 septic hips in 40 consecutive patients (20 males, 20 females) were treated with a two-stage total-hip-arthroplasty revision. Seventeen patients with 18 relevant procedures (44%) were reviewed at a mean follow-up of 52months. In 5 hips, an excision arthroplasty was present at review. Reimplantation had been performed in 13...
Article
Zusammenfassung Zur Behandlung von lokalen Knorpeldefekten stehen unterschiedliche Verfahren zur Auswahl, wobei es bezüglich der Therapieart bis heute keine einheitliche Meinung gibt. Grundsätzlich werden Therapieansätze mit oder ohne Chondrozytentransplantation unterschieden, die weiter in knochenmarkstimulierende Techniken und Transplantationstec...
Article
Matrix-associated autologous chondrocyte transplantation/implantation (MACT/MACI) is a new operation procedure using a cell seeded collagen matrix for the treatment of localized full-thickness cartilage defects. A prospective clinical investigation was carried out in order to clarify whether this proves suitable and confirms objective and subjectiv...
Article
Full-text available
This paper introduces a case of local pigmented villonodular synovits (PVNS) of the upper ankle joint in a 37-year old patient. PVNS is a neoplasia of the synovial membrane. Two different entities of PVNS are known: generalized diffuse and local nodular. They differ in their degree of destruction and growth configuration, which is crucial for progn...
Article
Microfracture of subchondral bone results in intrinsic repair of cartilage defects. Stem or progenitor cells from bone marrow have been proposed to be involved in this regenerative process. Here, we demonstrate for the first time that mesenchymal stem (MS) cells can in fact be recovered from matrix material saturated with cells from bone marrow aft...
Article
We studied the migration pattern, morphology and viability of cells suspended in five different fibrin glues. Besides this, the behaviour of chondrocytes seeded on porous matrices comprising different collagen types sealed with fibrin glue was investigated. In an experiment A, cell suspension (0.5x10(6) cells) was incubated with different fibrin gl...
Article
Full-text available
Zusammenfassung Zur Behandlung lokaler Knorpeldefekte stehen unterschiedliche Verfahren zur Auswahl. Grundsätzlich werden Therapieansätze mit oder ohne Chondrozytentransplantation unterschieden. Die Behandlungen reichen von der Mikrofrakturierung über die Transplantation autogener osteochondraler Zylinder (OATS) bis hin zur autologen Chondrozytentr...
Article
In this sheep study, we have tested the hypothesis that an osteogenic response is triggered in the subchondral bone by periosteum implanted in full thickness cartilage defects and can be prevented by replacing the periosteum by a cell-free collagen type I/III membrane. Two 7-mm diameter osteochondral defects were made in the trochlea groove and in...
Article
Bone cement is a widely used standard fixation substance in Orthopaedic Surgery. Cyanoacrylate glue is available for wound closure to supplement suturing. The mussel adhesive protein extracted from Mytilus edulis (Cell-Tak, BD Biosciences, Heidelberg, Germany) is an experimental fixation device used for in vitro purposes of cell adhesion. The aim o...
Article
For the treatment of full-thickness articular cartilage lesions of the knee joint, as a result of trauma or osteochondritis dissecans, a variety of biological reconstruction techniques have been developed. Different studies, some of which were performed as randomised, prospective clinical studies, showed that the autologous chondrocyte transplantat...
Article
Urogenital malformations, trauma or tumours may demand surgical reconstruction in children. Cell culture is an important technology in biomaterial research and tissue engineering. Tissue-engineering of urothelial organs is of interest in children, because the number of complications and re-operations may be reduced. Actually, monolayer cultures of...
Article
Hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP) are markers of collagen absorption and LP is specific for collagen type I in bone. In the present study we evaluated the concentration of HP and LP in urine of patients with osteosarcoma ( n=20; age range 16-49 years) and chondrosarcoma ( n=15; age range 18-70 years). The values were compared...
Article
The purpose of this study was to evaluate the biomechanical quality of cartilage and repair tissue in a sheep's knee. 4 standardized 7 mm defects were created on the medial femoral condyle and on the patellar groove (n = 22). These were treated with 4 different cartilage repair procedures and examined 1 year later. The different groups were: (1) a...
Article
Full-text available
We report a case of a 76-year-old-man who developed spontaneous hemarthrosis of his right knee following clopidogrel-aspirin treatment. Clopidogrel is an ADP receptor antagonist and in combination with aspirin widely used in patients with atherosclerotic vascular disease to reduce the incidence of ischemic events. To date, no case of spontaneous he...
Article
Determination of hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP) in urine is a promising method to determine bone resorption. This method is independent of gender, diet and kidney function (creatinine clearance > 25 mL/min). The diagnostic efficacy of HP and LP was assessed in the urine of adult patients suffering from primary malignant bo...
Chapter
Dieser Satz aus dem Jahr 1988 charakterisierte bereits die Bedeutung des Tissue engineering,übersetzbar als Gewebetechnologie.
Article
Chondrocytes in monolayer cultures lose their phenotype and capability to express type-II collagen, they dedifferentiate into a fibroblastic cell type. Using three-dimensional culture systems a redifferentiation of these cells may occur. In the present study we investigated the morphology and biosynthetic activity of human articular chondrocytes se...
Article
Tissue engineering may be a promising approach for the treatment of focal articular cartilage defects. Programmed cell death (apoptosis) plays an important role in multiple degenerative processes of cartilage (e.g. osteoarthritis). It is known that matrix provides a trophic signal for the cells and an altered matrix may influence the availability o...
Article
Full-text available
We studied the suitability of three different hydroxyapatite materials (Endobone, Bio-Oss and Algipore) as carriers for the bone growth promoting factor TGF-beta(1). The hydroxyapatite materials either were incubated for 24 h or directly loaded with hrTGF-beta(1) (Diagnostic Products Corporation, DPC) at a concentration of 10 ng hrTGF-beta(1)/mg. F...
Article
Hyaline articular cartilage is a specialised connective tissue with weight bearing and adsorbing functions. Injury or loss of which often leads to impaired joint function and severe pain. Since the self-renewing abilities of hyaline articular cartilage are limited, there is major interest in the development of bioengineered cartilaginous implants....
Article
The Ehlers-Danlos-Syndrom (EDS) is an inherited disorder of connective tissue which is characterised by the clinical triad of articular hypermobility, dermal extensibilitiy and cutaneous scarring. There is considerable variation in the extent to which individuals may be affected by EDS. There is a deficiency in diagnosis and therapy. In 1998 an int...
Article
Hyaline cartilage has only a limited capacity of regeneration, thus, lesions of articular cartilage can lead to early osteoarthrosis. Current concepts in conservative orthopedic therapy do not always lead to satisfying results. As one new attempt to facilitate cartilage repair, autologous transplantation of articular chondrocytes is investigated in...
Article
Full-text available
Different methods are available for the treatment of osseous defects. In recent years the use of autologous bone was established as the golden standard. However, significant disadvantages are limited availability of the bone graft and its harvest implies additional morbidity for the patient. Alternatives to the use of autologous bone, as allogeneic...
Article
Full-text available
Die Behandlung knöcherner Defekte erfolgt mit unterschiedlichen Methoden. Der „Goldstandard“ bei der Auffüllung von Knochendefekten ist die autogene Spongiosaplastik. Die Gewinnung erfolgt durch einen Zweiteingriff, der mit Komplikationen für den Patienten behaftet ist. Seit langem wird nach Alternativen zur Knochendefektbehandlung gesucht. Neben a...
Article
Different methods are available for the treatment of osseous defects. In recent years the use of autologous bone was established as the golden standard. However, significant disadvantages are limited availability of the bone graft and its harvest implies additional morbidity for the patient. Alternatives to the use of autologous bone, as allogeneic...
Article
A 82-year-old man with micropolyangiitis that required long-term steroid therapy had levofloxacin (500 mg/day) for 5 days for a brochopulmonary infection. He complained of pains in both Achilles tendons then difficulty in placing his right foot. On physical examination the tendons were swollen, very tender to palpation and apparent weakness of the...
Article
Owing to the poor regenerative capacity of cartilage, cartilaginous defects are considered to represent pre-arthrotic factors. In addition to autologous and allogenic osteochondral fragments, proliferative tissue, such as periosteum and perichondrium are increasingly being used as graft material. The aim of treatment is to eliminate the defect and...
Article
The regenerative capacity of hyaline articular cartilage is limited. Thus, lesions of this tissue are a proarthrotic factor, and up to now the conservative treatment of cartilage lesions and arthrosis does not yield satisfying results. Therefore, autologous transplantation of articular chondrocytes is being investigated in a variety of different as...
Article
The Ehlers-Danlos syndrome (EDS) comprises a heterogenous group of nine hereditary connective tissue disorders, characterized by hyperelasticity of skin and hypermobility of joints to differing extents. The skin is easily injured and wound healing is delayed. The majority of EDS patients belong to EDS-types I-III. The pathogenesis in these cases is...
Article
Malignant pelvic tumours are rare, but adequate treatment is difficult because of anatomical and functional reasons. Different surgical procedures are recommended. Besides aspects influencing the quality of life due to the different surgical techniques, costs of these surgical procedures and the perioperative time interval, depending on the chosen...
Article
Full-text available
Our aim was to examine the potential of autologous perichondral tissue to form a meniscal replacement. In 18 mature sheep we performed a complete medial meniscectomy. The animals were then divided into two groups: 12 had a meniscal replacement using strips of autologous perichondral tissue explanted from the lower rib (group G) and six (group C) se...
Article
A case of tuberculous arthritis complicating revision of a total hip replacement (THR) is reported. Primary THR was performed for arthrosis of the hip and the patient underwent revision because of aseptic loosening. After this surgical procedure, secondary infection with Mycobacterium tuberculosis occurred. Bacterial contamination due to haematogen...
Article
Our aim was to examine the potential of autologous perichondral tissue to form a meniscal replacement. In 18 mature sheep we performed a complete medial meniscectomy. The animals were then divided into two groups: 12 had a meniscal replacement using strips of autologous perichondral tissue explanted from the lower rib (group G) and six (group C) se...
Article
Osteochondritis dissecans belongs to the group of aseptic osteonecroses. The initial changes occur in the subchondral bone with the development of a circumscribed necrosis (stage I). It is followed by a surrounding sclerosis in the subchondral bone (Stage II). Following the natural course in stage III, the overlying articular cartilage is involved...
Chapter
Es werden die klinischen Ergebnisse der Therapie von tiefen Defekten des hyalinen Gelenkknorpels mittels autogener Transplantation von Rippenperichondrium an insgesamt 27 Patienten dargestellt. Nachuntersuchungsergebnisse von bisher 14 Patienten zeigen in allen Fällen eine deutliche Verbesserung der Werte im Lysholm- und Ranawat-HSS-Score.
Article
Es werden vergleichend die tierexperimentellen Ergebnisse der Therapie von tiefen Defekten des hyalinen Gelenkknorpels mittels autogener Transplantation von Rippenperichondrium anhand von 36 adoleszenten und 3 adulten Schafen dargestellt. Bei allen Schafen wurden am Kniegelenk je zwei 7 mm durchmessende tiefe Knorpeldefekte in der Patellagleitbahn...
Article
Full-text available
Complete repair of tears of the rotator cuff may be difficult, but with superior arthrolysis by the Apoil-Dautry technique the lesion in the cuff is not treated. We report 17 patients who had this procedure for large cuff defects. The outcome is directly related to the duration of symptoms, and we only had good results in a few patients, although i...