自体软骨细胞移植技术治疗膝关节软骨缺损11例报告

目的 评价自体软骨细胞移植技术(autologous chondrocytes implantation,ACI)治疗膝关节软骨缺损的有效性和安全性.方法 2012年6月至2014年6月,我院对11例(11处)膝关节软骨缺损患者实施ACI手术修复.患者平均年龄(26.91±6.92)岁,平均缺损面积(3.12±0.70...

Autologous chondrocyte implantation in the treatment of knee cartilage defects: long-term follow-up

Objective To evaluate the safety and efficacy of autologous chondrocyte implantation (ACI) for patients with knee cartilage defects.Methods ACI was performed on 11 patients (11 knees) from June 2012 to June 2013.The average age was (26.91±6.92) years,and the average size of each defect was (3.12±0.70) cm~2.Knee cartilage defects were confirmed by arthroscope.Autologous chondrocyte grafts were harvested from non-weight bearing areas of the knee for proliferation in-vitro,and then used to produce chondrocyte grafts.Grafts were subsequently rimmed to match the exact shape and size of the cartilage defects,and then positioned and fixed in place.Lysholm,IKDC and MRI were used to evaluate the clinic outcomes preoperatively,3 month postoperatively,2 years postoperatively,and at the final follow-up following a specific postoperative rehabilitation program.MOCART evaluation was carried out.Results Lysholm and IKDC scores were significantly improved after operation (P < 0.05).MRI 3 months postoperatively showed that the newly generated cartilage had almost completely filled the defect area but with an uneven surface;MRI 2 years postoperatively showed that the smooth and fully repaired cartilage integrated well with surrounding tissues;MRI at the final follow-up indicated that the chondrocyte graft had totally integrated with normal surrounding tissues with a smooth surface but no effusion.MOCART scores significantly increased along with the time (P < 0.05).No postoperative complications or ACI-related adverse events were noted.Conclusions ACI is safe and effective to repair knee cartilage defects with satisfactory long-term effects.