儿童和青少年的膝关节软骨修复

Research progress of articular cartilage repair of the knee in children and adolescents

越来越多的儿童和青少年出现关节软骨和软骨下骨的损伤。保守治疗无效时,儿童和青少年病人也应进行手术治疗。传统的成人关节软骨修复手术,同样适用于儿童和青少年,但必须根据损伤特征来制定个体化方案。自体软骨细胞移植具有良好的生物学潜力,尤其适用于关节表面较大的软骨缺损。近年来新兴的PRP和组织工程技术暂无在儿童和青少年中应用的报道。目前,尚无指南根据损伤大小给出明确治疗指导。制定治疗方案时,必须同时考虑软骨缺损大小和整个关节软骨表面积。此外,软骨下骨的损伤不容忽视。关节软骨修复技术在儿童和青少年中应用是安全的,并发症发生率与成人病人相比没有差异。

Children and adolescents are increasingly suffering from articular cartilage and osteochondral deficiencies Traumatic incidents often result in damage to the joint surfaces,Surgery is indicated in young patients when conservative measures fail. The operative techniques for articular cartilage injuries traditionally performed in adults may be performed in children,while an individualized approach must be tailored according to patient and defect characteristics. Autologous chondrocyte transplantation has good biological potential,especially for large cartilage defects on the joint surface. In recent years,emerging PRP and tissue engineering technologies have not been reported in children and adolescents. Clear guidelines for defect dimension-associated techniques have not been reported. Knee joint dimensions must be considered and correlated with respect to the cartilage defect size. In addition,the damage of the subchondral bone can not be ignored. Articular cartilage repair techniques appear to be safe in this cohort of patients,and no differences in complication rates have been reported when compared with adult patients.