细胞移植技术治疗距骨骨软骨损伤的研究进展

Research progress of cell transplantation in the treatment of osteochondral lesions of the talus

距骨骨软骨损伤(OLT)是踝关节外伤后常见的并发症,可导致踝部疼痛、肿胀和活动受限,严重影响患者的日常活动。其临床治疗方法包括非手术治疗和手术治疗,非手术治疗主要目的是缓解症状,持续有症状的OLT患者需行手术治疗。目前常用的手术治疗方法包括骨髓刺激术、自体骨软骨移植术和同种异体骨软骨移植术。骨髓刺激术用于治疗较小损伤面积的OLT,短期疗效良好,但长期预后尚不明确;自体骨软骨移植术可用于较大损伤面积的OLT,但易导致供体部位并发症;同种异体骨软骨移植手术成功率较低。近年来,细胞移植技术因其能够再生透明软骨样软骨、供体细胞来源广泛的优点,在治疗OLT方面受到越来越多的关注。因此,笔者就细胞移植技术治疗OLT的研究进展进行综述,为临床治疗提供参考。

Osteochondral lesions of the talus(OLT)frequently manifest following ankle joint trauma,causing ankle pain,swelling and impaired mobility,thereby significantly impeding daily activities of the patients.Presently,clinical treatment approaches encompass both conservative management and surgical intervention.Conservative management endeavors to alleviate symptoms,while patients experiencing persistent symptoms resort to surgical intervention.Commonly employed surgical treatments encompass bone marrow stimulation,autologous osteochondral transplantation,and allogeneic osteochondral transplantation.Bone marrow stimulation is employed as a therapeutic approach for the management of smaller OLT,demonstrating favorable short‑term effectiveness;however,the long‑term prognosis remains uncertain.Autologous osteochondral transplantation is a viable option for larger OLT lesions,albeit it carries the potential of complications at the donor site.Conversely,allogenic osteochondral transplantation exhibits a diminished success rate.In recent times,the utilization of cell transplantation techniques has garnered escalating interest in the treatment of OLT due to their capacity to regenerate cartilage resembling hyaline and their diverse range of cellular origins.The authors reviewed the progress of cell transplantation in the treatment of OLT,providing a reference for the clinical treatment.