脂肪源性基质血管组分在膝关节软骨损伤治疗中的短期临床疗效

Short⁃term Clinical Application of Adipogenic Matrix Vascular Component in the Treatment of Knee Cartilage Injury

目的探讨脂肪来源基质血管组分(SVF)对膝关节软骨损伤病例的短期治疗效果。方法前瞻性纳入2021年3月至2021年12月北部战区总医院收治的30例膝关节软骨损伤病例,经病人知情同意后行SVF关节腔注射治疗。其中男26例,女4例,年龄为(39.0±11.6)岁(22~58岁)。军事训练伤致软骨损伤24例,退变性软骨损伤6例。全部病例均为单侧膝关节注射。于治疗后3、6个月观察疼痛视觉模拟量表(visual analogue scale,VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(the West⁃ern Ontario and McMaster Universities Arthritis Index,WOMAC)及日本膝关节骨关节炎功能评估量表(the Japanese knee osteoarthritis measure,JKOM)评分。在治疗后6个月再次行膝关节MRI检查。结果全部病例均获随访,随访时间为(5.4±2.6)个月。治疗后3、6个月随访,VAS、WOMAC和JKOM评分均明显优于术前(P<0.05)。术后6个月随访MRI检查,与治疗前比较,软骨损伤信号未见明显缓解。病人未发生脂肪栓塞、深静脉血栓形成、感染等并发症。结论膝关节内注射SVF治疗膝关节软骨损伤的短期临床效果良好,值得在临床进一步推广应用。

Objective To investigate the effect and short⁃term therapeutic effect of adipose⁃derived stromal vascular fraction(SVF)on knee cartilage injury.Methods From March 2021 to December 2021,30 cases of knee cartilage injury were admitted to Northern Theater Command General Hospital.SVF was injected into the joint cavity with informed consent.There were 26 males and 4 females with age of(39.0±11.6)years(22⁃58 years).There were 24 cases of cartilage injury caused by military training and 6 cases of degenerative cartilage injury.All cases were given unilateral knee joint injection.Visual analogue scale(VAS),Western Ontario and McMaster Universities Arthritis Index(WOMAC)and the Japanese knee osteoarthritis measure(JKOM)were observed at 3,6 months after treatment.MRI was performed at 6 months after treatment.Results All patients were followed up for(5.4±2.6)months.VAS,WOMAC and JKOM scores at 3rd and 6th month after treatment were significantly better than those before operation(P<0.05).The follow⁃up MRI examination at 6th month after operation showed that the signal of cartilage injury was not significantly relieved as compared with that before treatment.There were no complications such as fat embolism,deep vein thrombosis and infection.Conclusion The short⁃term clinical effect of SVF injection in the treatment of knee cartilage injury is satisfactory,which is worthy of further clinical application.