创伤性骨软骨损伤治疗的研究进展

Research progress in the treatment of traumatic osteochondral leisions

创伤性骨软骨损伤(OL)在临床中常见,骨软骨在解剖上涉及软骨表面和软骨下骨,其解剖和生理功能存在特殊性,临床上处理OL时必须同时兼顾软骨及软骨下骨。目前对创伤性OL的手术及非手术治疗仍存在较多争议。而骨软骨组织工程多层支架设计更接近关节软骨到软骨下骨不同层次的解剖特性,目前已作为一个理想的选择应用于临床,以期达到更好地修复创伤性OL的效果。本文从骨软骨单元的解剖、功能,骨软骨损伤病理生理机制、诊断、治疗方法等方面对创伤性OL进行系统总结,并对当前研究的组织工程支架在创伤性OL中的应用进展进行综述。

In clinical practice,traumatic osteochondral lesions(OL)is common.The osteochondral unit involves cartilage surface and subchondral bone.Because of the particularity of the anatomy and physiological functions of the osteochondral unit,cartilage and subchondral bone must be taken into account when treating OL.There are still many controversies about the surgical and non-surgical treatment of traumatic OL currently.Multi-layered scaffold based on tissue engineering is more closer to the physiological characteristics from articular cartilage to the layer of subchondral bone,and it has been used in clinic as an ideal choice to achieve better therapeutic effect of traumatic OL.This paper summarizes traumatic OL from the anatomy and the function of the osteochondral unit,pathophysiological mechanism of OL,diagnosis and treatment methods of OL systematically,and the application of the tissue engineering scaffolds in traumatic OL in current research is also reviewed.