Treatment of articular cartilage injuries to the knee remains a considerable challenge today. Current procedures succeed in providing relief of symptoms, however damaged articular tissue is not replaced with new tissu...Treatment of articular cartilage injuries to the knee remains a considerable challenge today. Current procedures succeed in providing relief of symptoms, however damaged articular tissue is not replaced with new tissue of the same biomechanical properties and long-term durability as normal hyaline cartilage. Despite many arthroscopic procedures that often manage to achieve these goals, results are far from perfect and there is no agreement on which of these procedures are appropriate, particularly when full-thickness chondral defects are considered.Therefore, the search for biological solution in long-term functional healing and increasing the quality of wounded cartilage has been continuing. For achieving this goal and apply in wide defects, scaffolds are developed.The rationale of using a scaffold is to create an environment with biodegradable polymers for the in vitro growth of living cells and their subsequent implantation into the lesion area. Previously a few numbers of surgical treatment algorithm was described in reports, however none of them contained one-step or two –steps scaffolds. The ultimate aim of this article was to review various arthroscopic treatment options for different stage lesions and develop a new treatment algorithm which included the scaffolds.展开更多
Background Matrix-induced autologous chondrocyte implantation （MACI） is the third generation tissue-engineering technique for the treatment of full-thickness articular cartilage defects. The aim of this study was to...Background Matrix-induced autologous chondrocyte implantation （MACI） is the third generation tissue-engineering technique for the treatment of full-thickness articular cartilage defects. The aim of this study was to describe this new technique and the postoperative findings in adolescent knee with focal chondral defect. Methods The MACI consists of diagnostic arthroscopy and cartilage harvest, chondrocyte culture and seeding in tissue-engineering collagenous membrane, and implantation of the scaffold. Clinical outcome at minimum 1-year follow-up was assessed in seven patients （mean age （16.6＋1.5） years; 14-19 years） with full-thickness cartilage defects, with International Knee Documentation Committee （IKDC） score, the International Cartilage Repair Society （ICRS） score and the Knee Injury and Osteoarthritis Outcome Score （KOOS）. Besides, MR imaging was performed with T1 and T2-weighted imaging and three-dimensional spoiled gradient-recalled （3D-SPGR） MR imaging. Results Clinical evaluation showed significant improvement and MRI analysis showed that the structure was homogeneous and the implant surface was regular and intact in six patients, but irregular in one. Of all the seven patients, the cartilage defect site was nearly totally covered by the implanted scaffold. Conclusions These results indicated that MACI technique is an option for cartilage defect in adolescent knee joint, especially large defect of over 2 cm2. Long-term assessment is necessary to determine the true value of this technique.展开更多
文摘Treatment of articular cartilage injuries to the knee remains a considerable challenge today. Current procedures succeed in providing relief of symptoms, however damaged articular tissue is not replaced with new tissue of the same biomechanical properties and long-term durability as normal hyaline cartilage. Despite many arthroscopic procedures that often manage to achieve these goals, results are far from perfect and there is no agreement on which of these procedures are appropriate, particularly when full-thickness chondral defects are considered.Therefore, the search for biological solution in long-term functional healing and increasing the quality of wounded cartilage has been continuing. For achieving this goal and apply in wide defects, scaffolds are developed.The rationale of using a scaffold is to create an environment with biodegradable polymers for the in vitro growth of living cells and their subsequent implantation into the lesion area. Previously a few numbers of surgical treatment algorithm was described in reports, however none of them contained one-step or two –steps scaffolds. The ultimate aim of this article was to review various arthroscopic treatment options for different stage lesions and develop a new treatment algorithm which included the scaffolds.
文摘Background Matrix-induced autologous chondrocyte implantation （MACI） is the third generation tissue-engineering technique for the treatment of full-thickness articular cartilage defects. The aim of this study was to describe this new technique and the postoperative findings in adolescent knee with focal chondral defect. Methods The MACI consists of diagnostic arthroscopy and cartilage harvest, chondrocyte culture and seeding in tissue-engineering collagenous membrane, and implantation of the scaffold. Clinical outcome at minimum 1-year follow-up was assessed in seven patients （mean age （16.6＋1.5） years; 14-19 years） with full-thickness cartilage defects, with International Knee Documentation Committee （IKDC） score, the International Cartilage Repair Society （ICRS） score and the Knee Injury and Osteoarthritis Outcome Score （KOOS）. Besides, MR imaging was performed with T1 and T2-weighted imaging and three-dimensional spoiled gradient-recalled （3D-SPGR） MR imaging. Results Clinical evaluation showed significant improvement and MRI analysis showed that the structure was homogeneous and the implant surface was regular and intact in six patients, but irregular in one. Of all the seven patients, the cartilage defect site was nearly totally covered by the implanted scaffold. Conclusions These results indicated that MACI technique is an option for cartilage defect in adolescent knee joint, especially large defect of over 2 cm2. Long-term assessment is necessary to determine the true value of this technique.
