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Cartilage

Cartilage is part of the subcutaneous and connective tissue that physio-genetically derives from the mesenchym. The mesenchym is the embryonic connective tissue (first 3 pregnancy months) that develops mesenchymal multipotent stem cells. These multipotent stem cells (capable to differentiate into various tissue) later build all cells of the subcutaneous and connective tissue, such as bone, cartilage, tendons, muscle and vessels. Cartilage is a highly specialized, tight connective tissue that is composed of three elements: first, the cartilage cell that produces the second element, the slimy-jelly substance called the intercellular substance. It is made of proteoglykan-molecules and hyaluronic acid (hydrophilic). The third element is a collagen fiber type II (IX and XI). An important protein, called aggrecan, connects all three elements – the cartilage cell, the proteoglycan and the collage fiber. The collagen-net and the slimy intercellular substance make up 95 – 98 % of cartilage, its extracellular (outside of the cell) matrix, they are responsible for its firmness and elasticity (biomechanics). Only 2- 5 % of cartilage is built of actual cartilage cells, stored individually or in groups in the extracellular matrix.

Due to various possible configurations of the three elements, we can distinguish three natural kinds of cartilage: fibrous cartilage, elastic cartilage and hyaline cartilage. Hyaline joint- and vertebral cartilage is a highly specialized tissue; its function is the buffering of high mechanic impacts that affect our joints and spine on a daily basis. Only the complex hyaline cartilage is capable to withstand these heavy burdens, fibrous cartilage is unsuitable.

In order to understand the effects of our new regenerative therapies, we must first – in a simplified manner – understand the metabolism of hyaline cartilage. Injured hyaline cartilage is only capable to repair itself in children, grown up cartilage is no longer connected nor supplied through the vascular system. This restricted supply of the now disconnected cartilage cell is responsible for all degenerative processes – called arthritis – that (can) arise after cartilage injuries. It takes a whole lot of nutrition in order to supply the highly active cartilage cells that, aside of their many important cellular metabolic processes, produce proteoglycane and collagen II.

Joint and vertebral cartilage is the largest connected, non-vascularized tissue of the entire organism. Its nutrition can only be maintained by the „soup“ that surrounds it – the synovial fluid. This fluid is produced by the synovia, the skin of the joint, it acts on one hand a lubricant for the joint and as nutrition of the cartilage. The main mechanism to get the nutrition into the cartilage cells is called diffusion; it is highly dependant on the water content of the cartilage. Water is not a free molecule a joint, but is rather a structural component of the macromolecules that can hold water even against strong pressure loading. 

A mechanical pump-mechanism that is activated by the elasticity of the cartilage is equally important for the nutrition and detoxication of cartilage. Compressed cartilage compresses like a sponge and decompresses when the mechanical stress subsides; during the decompression it soaks up nutritious fluid and during compression it releases metabolic waste. Only healthy and active cells are capable to synthesize proteoglycane and collagen II, in order to provide enough of fluid for a healthy metabolism.

Each acute injury or degenerative change of the joint cartilage influences the synthesis ratio of proteoglycane and collagen and the biomechanical properties of the cartilage. A decreased water and nutrition supply, deteriorated elasticity and buffer quality lead to arthritis. It is extremely difficult to break this adverse circle with today’s therapies.

Aim of our new therapy concepts is a positive intervention into the progressive arthritic processes on the cellular level in order to improve the metabolism and functionality of injured and degenerated cartilage.

 

 

 

 

 

 

Therapy Spectrum 

 

ACS - Autologous Conditioned Serum

 

ACP - Autologous Conditioned Plasma

 

ACBM - Autologous Concentrated Bone Marrow

 

Hyaluronic Acid

 

Alternative Therapies 

 

Homeopathy 

 

DNA Analysis