移植基质诱导的自体软骨细胞修复关节软骨缺损临床研究

Matrix-induced autologous chondrocytes implantation for repairing articular cartilage defect

目的 探讨基质诱导的自体软骨细胞移植修复关节软骨缺损的方法与疗效.方法 2004年11月～2006年11月,对7例膝关节软骨炎患者行关节镜取软骨、基质诱导自体软骨细胞移植（Matrix-induced Autologous chondrocyte implantation,MACI）膜植入术.对患者行MRI检查确定损伤位置,并进行IKDC2000评分.术后按照特定的康复计划进行循序渐进的功能锻炼.结果 随访时间6个月到24个月.术后半年多数患者各项症状逐渐消失,IKDC2000评分大部分增高.复查MRI和关节镜,显示原来缺损的关节软骨已基本修复,并伴有软骨下骨的修复.结论 与传统自体软骨细胞移植（Autologous chondrocyte implantation,ACI）技术相比,利用MACI技术修复软骨缺损具有术后恢复时间短、操作简便、创伤小、生成更多透明软骨等优点,具有良好的应用前景.

Objective To study the methods and therapeutic effects of matrix- induced autologous chondrocytes implantation （MACI） for repairing articular cartilage defect. Methods Between November 2004 and November 2006, we performed MACI on seven patients with knee joint osteochondritis,including 6 men and 1 woman.The age ranged from 14 to 57 with a mean of 34.7. We localized the position of defect by MRI, and calculated the IKDC2000 scores of patients. Patients did functional exercises in a gradual and progressive way according to a rehabilitation proglam after the surgery. Results All the seven patients were followed up for 6 to 24 months. Six months after the surgery, symptoms were eliminated gradually in most patients ; their IKDC2000 scores were also improved. MRI and arthroscopy showed that the defects of articular cartilage was mostly repaired, and the subchondral bone was also repaired. Conclusions Compared with the traditional ACI technique,MACI has the advantages of short recovery time,convenient operation,slight trauma,and larger amount of hyaline cartilage. We believe that the MACI technique will have a promising perspective.