关节软骨损伤的外科治疗进展

Progress in the Surgical Treatment of Articular Cartilage Injury

关节软骨在人体关节活动中发挥重要作用,而各种原因造成的软骨损伤对患者的生理运动、生活质量产生严重影响。由于关节软骨缺少血管和神经,非手术治疗对软骨损伤的治疗效果十分有限,所以外科治疗成为临床治疗软骨损伤的主要方式,其治疗思路为通过生物性或非生物性的材料重构损伤的软骨结构。目前,临床治疗主要包括清创、微骨折术、自体软骨植入、异体软骨植入、自体软骨细胞植入、组织工程、关节腔注射等,这些治疗手段应用的范围略有差别,但对患者均有明显的治疗效果。未来,组织工程技术、细胞因子诱导将成为研究热点。

Articular cartilage plays an extremely important role in human joint activities, and cartilage injury can have a serious negative impact on the patient＇s physiological movement and quality of life. Due to the lack of articular cartilage of blood vessels and nerves, non-operative treatment has very limited effect on the treatment of cartilage injury, so surgical treatment has become the main way to treat cartilage injury in clinical practice, the idea of which is through the biological or non-biological material to restore the damaged cartilage structure. At present, the clinical treatment includes debridement, microfracture, autologous cartilage implantation, allogeneic cartilage implantation and autologous chondrocyte implantation, tissue engineering, articular injection and so on. The apphcation scope of these treatments vary slightly,but all have obvious therapeutic effect. In the future, tissue engineering and cytokine induction will become the focus of the research.