Info & FAQs

• In short: RECARTA® is an advanced autologous chondrocyte transplantation procedure designed to restore focal knee cartilage defects using your own cartilage cells.
• Performed by: Experienced orthopaedic surgeons specialising in knee cartilage restoration.
• Treatment plan: Two minimally invasive arthroscopic procedures approximately four weeks apart.
• Hospital stay: Day surgery for the first procedure (cartilage biopsy). Usually one overnight stay after the second procedure (cartilage implantation).
• Anaesthesia: General or regional anaesthesia, depending on your individual case.
• Recovery: A personalised rehabilitation programme is essential following implantation (rehabilitation is not included in the package price).
• Treatment package: €10,700 (includes both surgical procedures, RECARTA® preparation, hospital care, personal travel manager, 24/7 assistance and local transportation. Rehabilitation, flights and accommodation are not included.)

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Autologous chondrocyte implantation (RECARTA®) is an advanced regenerative medicine procedure designed to restore damaged cartilage of the knee joint. This methodology is especially useful for patients who need restoration or improvement of articular cartilage.

Before deciding on this procedure, it is necessary to consult specialists and assess the patient’s health, including the condition of the joints, the severity of symptoms and quality of life. The suitability of RECARTA® for a particular case must be assessed by specialists.

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Ideal candidates

The ideal candidate for the RECARTA® procedure is an active individual with a symptomatic focal cartilage defect that has not responded to conservative treatment and does not have widespread osteoarthritic changes in the joint.

Injuries

For patients who have suffered damage to the articular cartilage as a result of knee injuries or excessive exertion. RECARTA® can be an ideal choice for professional athletes, physically active individuals or recreational athletes who want to restore joint function and return to their normal level of activity.

Age

Generally, patients between 18 and 65 years of age are considered. This is because younger patients tend to have better regenerative capacity, while treatment may be less effective in elderly patients due to advanced degenerative changes.

Lesion size and location

• A single cartilage defect is typically greater than 2 cm² and up to 10 cm² in size.
• The lesion should be located in weight-bearing areas of the knee, such as the medial or lateral femoral condyles. The treatment can also be used for patellar lesions or talar lesions in the ankle.
• It is not intended for patients with diffuse cartilage loss or generalised osteoarthritis.

Symptoms

• Persistent symptoms may include pain, swelling and mechanical symptoms, such as locking or giving way.
• Symptoms do not respond adequately to conservative treatments, such as physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs) or other non-operative modalities.
• Patients are active and wish to return to higher levels of physical activity, including recreational or competitive sports.

Radiological findings

• MRI confirmation of a full-thickness grade III–IV cartilage defect without widespread osteoarthritic changes.
• X-rays do not show advanced osteoarthritic changes in the joint.

Previous surgeries

• Ideally, patients have not had previous major surgery on the joint.
• However, patients with prior unsuccessful cartilage repair procedures, such as microfracture or osteochondral grafting, may still be candidates and should be evaluated individually.
• There should be no malalignment or joint instability. If present, these issues may need to be addressed either before or during the RECARTA® procedure to ensure the best possible outcome.

First procedure – cartilage biopsy harvest

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1. Preparation

• The patient is prepared for arthroscopy, a short and minimally invasive procedure.
• The surgical site is cleaned, and local or general anaesthesia is administered.

2. Procedure (30 minutes)

• Small incisions, usually two or three, are made in the front part of the knee joint.
• An arthroscope, a small camera, is inserted to visualise the inside of the joint.
• The cartilage defect is located, cleaned and measured.
• Healthy cartilage tissue from a non-weight-bearing area of the damaged knee is identified.
• A small cartilage biopsy sample is harvested using special instruments and placed in a specialised transport solution.

3. End of procedure and recovery

• The incisions are closed using stitches or staples.
• A dressing is applied, and the patient is moved to the recovery room.
• The patient usually returns home the same day.

4. Shipment for manufacturing

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The cartilage biopsy sample is placed in a special nutrient-rich medium and secured in a temperature-controlled transport carrier. The carrier is transferred to an accredited clean-room laboratory facility, where the preparation process takes approximately 4 weeks.

Specialised, natural cartilage-forming cells are isolated and multiplied into millions of cells through an advanced biotechnological and strict quality-controlled process, usually over 3–4 weeks. After passing quality control tests, RECARTA® is released for implantation.

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Second procedure – cartilage transplantation

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1. Preparation

• The patient is prepared for arthroscopy, a minimally invasive procedure.
• The surgical site is cleaned, and local or general anaesthesia is administered.

2. Procedure (45 minutes)

• Small incisions, usually two or three, are made in the front part of the knee joint.
• The damaged cartilage area is prepared to receive the transplant. This involves removing damaged tissue and shaping the defect to fit the graft.
• The graft is then sized and trimmed to fit the defect precisely.
• Cartilage-forming cells are combined with a biological scaffold for improved attachment and proliferation.
• The tissue-engineered product is introduced back into the defect, and cartilage regeneration begins.

The joint is checked for any issues, such as graft movement or instability.

3. End of procedure and recovery

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• The incision is closed with stitches.
• A dressing is applied, and the patient is moved to the recovery room.
• The knee is typically immobilised using a textile brace to protect the graft.

Knee cartilage repair using RECARTA® addresses the physical challenges caused by cartilage defects. It may enhance patients’ quality of life by reducing pain, improve joint function and potentially help avoid more invasive procedures in the future.

1. Pain relief: Cartilage defects, especially in weight-bearing joints such as the knee, can cause significant pain. This treatment may help alleviate pain by promoting the growth of new functional cartilage.
2. Improved mobility: Damaged cartilage can impede joint movement and lead to stiffness. By restoring the cartilage surface, this treatment may enhance joint flexibility and overall mobility.
3. Delay or prevention of arthritis: Untreated cartilage defects can accelerate the development of osteoarthritis. By addressing the defect, this treatment may potentially delay or prevent the onset of arthritis in the affected joint.
4. Natural joint function: RECARTA® uses the patient’s own chondrocytes (cartilage cells), resulting in the growth of cartilage that is more akin to the patient’s natural cartilage compared with some other methods or treatments.
5. Avoiding joint replacement: For some patients, if left untreated, the next step might be joint replacement. Knee cartilage repair offers an alternative that may help preserve the patient’s joint.
6. Treatment of larger defects: This treatment may be used for larger cartilage defects that might not be suitable for other types of cartilage repair procedures.
7. Long-term solution: While the recovery period after knee cartilage repair can be lengthy, the results are intended to be long-lasting, providing patients with a durable solution for cartilage defects.

The matrix-induced chondrocyte implantation procedure using RECARTA® consists of two short procedures:

First procedure: cartilage biopsy harvest — retrieval of cartilage cells.
Second procedure: cartilage transplantation — RECARTA® transplantation approximately one month later.

Preparation for the first procedure:

• Consultation: Symptoms such as knee pain, swelling, crackling and locking frequently interfere with preferred activities and can cause discomfort. A detailed examination of the joint is performed to determine the defect’s location, size and overall joint health.
  Call to action: Book a consultation with an orthopaedic surgeon providing RECARTA®.
• Imaging: Magnetic resonance imaging (MRI) and X-rays provide insight into cartilage defects and joint structures.
  Call to action: An orthopaedic surgeon will write a referral for an X-ray and MRI.
• Health review: A thorough review of your medical history, including allergies, previous surgeries and underlying health conditions.
  Call to action: A family doctor and an orthopaedic surgeon will review your health.
• Medication review: Share all medications, supplements and over-the-counter medicines you are taking. Some may require adjustment or discontinuation.
  Call to action: A family doctor and an orthopaedic surgeon will review your medication.

Laboratory tests: Blood tests are used to check for any concerns that might affect the procedure or anaesthesia. Tests include:

1. Complete blood count (CBC): to assess general health and detect disorders such as anaemia or infection.
2. Coagulation profile: including prothrombin time (PT) and partial thromboplastin time (PTT). It is important to know how the patient’s blood clots, especially if they are taking medications such as warfarin or aspirin.
3. Blood chemistry panel: including electrolytes, kidney function, liver enzymes and glucose levels.
4. Inflammatory markers: such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), which can provide insight into inflammation in the body.

Call to action: An orthopaedic surgeon will provide your family doctor with a list of essential laboratory tests to be performed before surgery.

1.Post- procedures:

• Rest and recovery: After both procedures, follow your surgeon’s instructions regarding activity levels, wound care and pain management.

2. Follow-up appointments

• Attend all scheduled follow-up appointments after transplantation to monitor healing and ensure that the graft is integrating properly.

3. Rehabilitation

• Physical therapy is crucial after the RECARTA® procedure. Initially, rehabilitation focuses on restoring joint movement, followed by strengthening exercises.
• Weight-bearing on the operated joint will be limited for a period determined by your surgeon.
• Cartilage regeneration is supported through a personalised rehabilitation programme. Following RECARTA® implantation, you will receive an individual concierge-style rehabilitation programme. Regular follow-up appointments will monitor the regeneration process, while a comprehensive rehabilitation programme is designed to help protect the newly formed cartilage and support long-term knee function.

1. Physical conditioning

• Preoperative physical therapy: Engage in physical therapy to strengthen the muscles around the joint and improve its range of motion. Follow a low-impact exercise programme to enhance joint health and overall physical fitness.Call to action: An orthopaedic surgeon will write a referral for physiotherapy and provide you with exercise videos and a physical therapy programme.

2. Lifestyle considerations

• Smoking: Stop or reduce smoking. Smoking compromises blood flow, which can impair wound healing, increase the risk of infection and delay recovery, as with any surgical procedure.Call to action: An orthopaedic surgeon will provide an actionable plan to help you reduce or quit smoking.
• Diet: Eat a balanced diet rich in protein, vitamins and minerals, and stay well hydrated.Call to action: An orthopaedic surgeon will provide personalised dietary recommendations.

3. Pre-operative preparations

• Home setup: Make sure your home is prepared for your recovery. This may include arranging walking aids, such as crutches, or creating a dedicated recovery space.
• Fasting: Do not eat or drink anything after midnight before the cartilage biopsy procedure.
• Hygiene: Shower with antibacterial soap before the biopsy.Call to action: An orthopaedic surgeon will provide guidance to help you prepare for optimal post-operative recovery.