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Modern biological therapies aim to preserve and restore the articular surface, offering advanced solutions to athletes and active patients who wish to safely return to their daily activities.

The role of cartilage & the importance of maintaining the joint

The articular cartilage functions as a protective “cushion” within the joint, ensuring smooth and painless movement of the joint, while significantly reducing friction between the bones.

When articular cartilage is damaged or worn, its ability to protect the joint is significantly reduced, which can lead to:

• pain

• stiffness

• reduce functionality

• early osteoarthritis

With the development of biological and regenerative therapies, targeted cartilage restoration and joint preservation are now feasible and realistic goals, allowing patients to avoid more invasive methods and return to an active lifestyle faster.

Biological Therapies

PRP – Platelet-Rich Plasma

PRP is derived from the patient’s own blood and is a platelet concentrate, rich in growth factors that:

• reduce inflammation

• enhance the regenerative process

• support the healing of cartilage damage

It is one of the most important tools in modern regenerative orthopedics, with applications in both the treatment of in chronic injuries, as well as in the targeted support of joint rehabilitation. 

BMAC – Bone Marrow Aspirate Concentrate

BMAC is derived from bone marrow. Contains:

• mesenchymal stem cells

• incremental factors

• regenerative cells of low differentiation and high biological activity

This is a highly advanced biological therapy, with an important role in the repair of cartilage damage and in maintaining joint functionality

Surgical Techniques for Cartilage Restoration

Nanofracture Plus (NFx+): The modern evolution of microfractures

The Nanofracture Plus (NFx+)  technique is the newest and most advanced form of the microfracture method. Unlike the classic technique, NFx+: 

• creates deeper and thinner channels in the subchondrium bone

• allows better biological penetration

• combined with PRP, BMAC or specialized membranes

• promotes the creation of more durable and homogeneous fibrocartilage

It is an excellent choice for small to medium cartilage lesions, especially in young and athletically active patients.

AMIC – Autologous Matrix-Induced Chondrogenesis

TheAMIC method combines the microfracture technique with the use of a special collagen membrane, which:

• retains mesenchymal cells

• stabilizes the biological environment

• contributes to more predictable and stable cartilage regeneration

Indicated for medium-sized cartilage lesions, especially in the knee and ankle

MACI – Matrix-Induced Autologous Chondrocyte Implantation

MACI reproduces the structure of natural hyaline cartilage and offers long-term stable results, even in large or complex lesions. 

The MACI technique is the most advanced cellular method of cartilage restoration.

Basic steps of the procedure:

1. Taking a small sample of healthy cartilage from the patient
2. Cultivation and proliferation of chondrocytes in the laboratory
3. Implantation of the cultured cells onto a special membrane, which is placed and stabilized in the area of damage

MACI achieves cartilage regeneration with characteristics similar to natural hyaline cartilage and offers long-term, stable clinical results, even in large, complex or chronic cartilage lesions.

Osteochondrial Grafts

OATS / Mosaicplasty (Autologous Grafts)

This technique uses cylinders of osteochondral tissue, which are taken from a non-load-bearing area of ​​the patient’s joint and placed at the site of the lesion. They are mainly indicated for deep, focal, traumatic lesions.

The main advantage is the immediate placement of full-thickness tissue of natural cartilage, offering stable mechanical support and high quality regeneration.

Osteochondral Allografts

Osteochondral allografts are used when the extent or nature of the of the lesion does not allow the use of autologous tissue. Indicated in cases of:

• extensive cartilage lesions

• severe destruction of the subchondral bone

• failure of previous invasive techniques

They are an effective solution when the available autologous tissue is not sufficient, offering full-thickness osteochondral restoration in demanding and complex lesions.

Integrated approach to joint preservation

The successful treatment of cartilage lesions is based on a comprehensive and personalized process that includes:

• detailed clinical assessment

• specialized imaging tests (MRI, T2 mapping)

• personalized treatment plan

• minimally invasive surgical techniques

• specialized and targeted rehabilitation

• safe and gradual return to activity

With modern techniques preservation of the joint we achieve:

• significant reduction in pain

• improve everyday functionality

• delaying the progression of osteoarthritis

• high level of performance for athletes and demanding patients

The specialized Orthopedic and Sports Injuries Clinic of the Athens Medical Center, under Dr. Andreas Piskopakis, who received further training in the United States under Harvard University Professor, Dr. Tom Minas, provides modern and evidence-based therapeutic solutions, always with respect for the patient’s needs and with the aim of excellent functional rehabilitation.