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
目的探讨基质诱导自体软骨细胞移植修复膝关节软骨损伤的可行性及早期疗效。方法回顾性分析2012年4月至2013年3月13例单侧膝关节局灶性软骨缺损患者资料，男11例，女2例；年龄19-37岁，平均27．5岁；膝关节软骨缺损面积2．3-7．5cm^2，...目的探讨基质诱导自体软骨细胞移植修复膝关节软骨损伤的可行性及早期疗效。方法回顾性分析2012年4月至2013年3月13例单侧膝关节局灶性软骨缺损患者资料，男11例，女2例；年龄19-37岁，平均27．5岁；膝关节软骨缺损面积2．3-7．5cm^2，平均4．2cm^2；国际软骨损伤修复协会（ICRS）分级为Ⅲ级3例，Ⅳ级10例，均出现膝关节疼痛症状[视觉模拟评分（visual analogue scale，VAS）〉3分]。13例患者均使用基质诱导软骨细胞移植技术进行软骨细胞移植。术后进行规范化功能康复锻炼。结果术后随访1年，1例患者因术后6：5个月下楼梯时扭伤膝关节致半月板损伤行关节镜下半月板修补术而剔除该患者术后12个月的评分，以避免结果偏倚。膝关节活动度，术后3个月（123．1°±8．0°）较术前（135．4°±5．7°）减少，膝关节损伤和骨关节炎评分（kneeinjury and use osteoarthritis outcomescore，KOOS）的5个子集均较术前降低，Lysholm评分[（65．7±9．4）分]较术前[（71．2±12．3）分]无明显变化，国际膝关节评分委员会评分（International Knee Documentation Committee，IKDC）[（26．1±3．9）分]较术前[（43．5±6．5）分]减少；术后6、12个月的膝关节活动度（136．1°±6．1°、135．1°±3.6°）、Lysholm评分[（80．6±9．6）分、（86．6±9．2）分]、IKDC评分[（53.3±5．8）分、（62．8±7．2）分]、KOOS评分均较术前明显提高。术后12个月软骨修复组织磁共振评分[（73．3±17．9）分]较术前[（51．5±12．6）分]明显提高。结论基质诱导自体软骨细胞移植技术可有效修复膝关节软骨损伤，改善膝关节功能，具有良好的近期疗效。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.
文摘目的探讨基质诱导自体软骨细胞移植修复膝关节软骨损伤的可行性及早期疗效。方法回顾性分析2012年4月至2013年3月13例单侧膝关节局灶性软骨缺损患者资料，男11例，女2例；年龄19-37岁，平均27．5岁；膝关节软骨缺损面积2．3-7．5cm^2，平均4．2cm^2；国际软骨损伤修复协会（ICRS）分级为Ⅲ级3例，Ⅳ级10例，均出现膝关节疼痛症状[视觉模拟评分（visual analogue scale，VAS）〉3分]。13例患者均使用基质诱导软骨细胞移植技术进行软骨细胞移植。术后进行规范化功能康复锻炼。结果术后随访1年，1例患者因术后6：5个月下楼梯时扭伤膝关节致半月板损伤行关节镜下半月板修补术而剔除该患者术后12个月的评分，以避免结果偏倚。膝关节活动度，术后3个月（123．1°±8．0°）较术前（135．4°±5．7°）减少，膝关节损伤和骨关节炎评分（kneeinjury and use osteoarthritis outcomescore，KOOS）的5个子集均较术前降低，Lysholm评分[（65．7±9．4）分]较术前[（71．2±12．3）分]无明显变化，国际膝关节评分委员会评分（International Knee Documentation Committee，IKDC）[（26．1±3．9）分]较术前[（43．5±6．5）分]减少；术后6、12个月的膝关节活动度（136．1°±6．1°、135．1°±3.6°）、Lysholm评分[（80．6±9．6）分、（86．6±9．2）分]、IKDC评分[（53.3±5．8）分、（62．8±7．2）分]、KOOS评分均较术前明显提高。术后12个月软骨修复组织磁共振评分[（73．3±17．9）分]较术前[（51．5±12．6）分]明显提高。结论基质诱导自体软骨细胞移植技术可有效修复膝关节软骨损伤，改善膝关节功能，具有良好的近期疗效。
