摘要
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。
Objective To study the feasibility and early efficacy of matrix-induced autologous chondrocyte implantation repairing knee joint cartilage injury. Methods The Matrix-induced autologous chondrocyte implantation was used to repair knee joint cartilage injury in 13 cases （11 males and 2 females） with knee joint cartilage injury from April 2012 to March 2013. The average age was 27.5 years old. All cases were suffering from unilateral focal cartilage defect of knee joint with International Cartilage Repair Society （ICRS） chondral defect classification system grade III or IV, visual analogue scale （VAS） 〉 3, and all of which had corresponding pain symptoms. The average defect area was 4.2 cm：. Standardized rehabilitation exercise was carried out after matrix-induced autologous chondrocyte implantation, Patients were followed up for 1 years, and knee injury and use osteoarthritis outcome score （KOOS）, International Knee Documentation Committee （IKDC）, subjective knee form and Lysholm score were collected to assess the function. Meanwhile, magnetic resonance observation of cartilage repair tissue （MOCART） score was used to assess the magnetic resonance imaging. Results All patients had been followed-up for 1 year. One patient had meniscus repair under arthroscopy for the meniscus injury caused by downstairs sprain in 6.5 months postoperative, so the score of 12 months postoperative was excluded. The knee range of motion was decreased in 3 months postoperative （123.1°±8.0°） compared to preoperative one （135.4°±5.7°）, and has no difference in 6 months （136.1°±6.1°） and 12 months postoperative （135.1°±3.6°） compared to preoperative one. The 5 subsets of KOOS score were decreased in 3 months compared to preoperative one, and were significantly increased in 6 months and 12 months. The IKDC has no difference in 3 months （26.1±3.9） compared to preoperative one （43.5±6.5）, and were significantly increased in 6 months （53.3±5.8） and 12 months （62.8±7.2） compared to preoperative one. The magnetic resonance observation of cartilage repair tissue （MOCART） score was increased in 12 month（73.3±17.9） compared to preoperative one （51.5±12.6）. Conclusion MACI is a good technology for knee joint cartilage injury. It has a good clinical effect on repairing cartilage injury effectively and restoring the function of knee joint.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2016年第1期28-34,共7页
Chinese Journal of Orthopaedics
基金
广东省科技计划项目（20128031800188）
广东省医学科研基金（B2014316）
广东省自然科学基金（2014A030310147）
全军医学科技青年培育项目（2014A030310147）
关键词
软骨细胞
移植
自体
膝关节
Chondrocytes
Transplantation, autologous
knee joint
