关节镜下自体骨软骨移植修复软骨缺损的临床研究

目的取非负重区软骨替代负重区病变软骨,探讨软骨缺损的修复方式.方法对膝关节负重面软骨缺损的患者采用关节镜下非负重面自体骨软骨移植,根据缺损大小选择不同大小的骨软骨移植物,术后行CPM功能锻炼1周,6周后负重行走.结果术后随访3～24月,所有患者膝关节活动良好,疼痛症状基本消失,复查MRI示原软骨缺损区软骨表面光滑,移植物位置良好.结论关节镜下自体骨软骨移植效果良好,创伤小,避免同种异体移植产生的排斥反应及疾病的传播,是修复软骨缺损的好方式.

The clinical research of autograft cartilage transplantation treating cartilage defect in arthroscopy

Objective To investigate the methods to repair cartilage defect. This paper describes the results of clinical experience with autologous osteochondral mosaicplasty. Methods Osteochondritis dissecans of the knee is a challenging clinical problem. The 25 patients with chondral and osteochondral defects of the weight-bearing surfaces were treated by transplantation of chondral and osteochondral defects of the unweight-bearing surfaces in arthroscopy. According to the shape of defect ,the different dimensions osteochondral autograft were selected. All patients were taken training of continuous passive motion post-operation. At 6 weeks after operation, the patients began to walk in weight-bearing habitus. Result A follow-up examination were carried out at three and twenty-four months post-operation. The knee joint operated had good motion extent. The symptom of pain was allievated obviously. we performed a longitudinal study with three-dimensional spoiled magnetic resonance imaging (MRI). The signal intensity of reparative tissue approached that of normal articular cartilage with time. Conclusions MRI is thought to be useful for evaluating reparative tissue after autologous chondrocyte implantation. We conclude that cartilage-bone-transplantation of the knee is a valuable procedure to improve joint function not only after trauma, but also in joints with local arthritic lesions on condition that there is an adequate quality of the donor site. The methods avoid the possibility of conveying infective diseases.