慢速梯度降温冷冻保存同种异体骨软骨移植治疗膝关节全层软骨缺损(附三例报告)

目的总结冷冻保存同种异体骨软骨移植物治疗3例膝关节全层骨软骨缺损的手术方法及疗效。方法应用梯度降温冷冻保存的6枚同种异体骨软骨移植物治疗3例膝关节全层骨软骨缺损,2例在关节镜下同种异体骨软骨移植,1例行关节切开移植。膝关节股骨髁关节软骨全层缺损平均面积2.16 cm2。所有患者在手术后第1个月、第3个月时进行膝关节MRI检查,了解移植物与周围骨软骨组织的愈合情况。并于门诊复查时进行Brittberg-Peterson膝关节功能评分,了解功能恢复情况。结果随访4～6个月,平均4.7个月。所有患者术后疼痛消失;无排异反应发生。术后3个月时,MRI检查示术后移植物与宿主软骨下骨整合良好,移植软骨组织结构与内部信号良好。Brittberg-Peterson评分术后6个月比手术前明显降低。结论经梯度降温冷冻保存的同种异体骨软骨移植治疗膝关节软骨缺损早期效果满意。

Osteochondral allografts of step cooling cryopreservation for repair of full-thickness articular cartilage defect of knee joint(report of 3 cases)

Objective To introduce the repair method of full-thickness articular cartilage of knee join through osteochondral allograft of step cooling cryopresercvation and its early clinical outcome.Methods Three patients who suffered from full-thickness defect of knee articular cartilage were treated by transplantation of osteochondral allograft cryopreserved in step cooling under arthroscopy or arthrectomy.The average cartilage defect was 2.16 cm2.All patients were examined by MRI to display the integrating of allograft with surrounding tissues at 1st month,3rd month postoperatively,and evaluate the function of operative knee through Brittberg-Peterson score system.Results The average follow-up time was 4.7 months(range: 4~6 months).All patients’ pain disappeared.The Brittberg-Peterson score decreased remarkably from 97.5 preoperatively to 10.0 at six months postoperatively.The integration of allograft with subchondral bone surrounding was well,and the structure and internal signal of allograft cartilage was same as normal cartilage surrounding.No immunology rejection was found.Conclusion The clinical outcome of full-thickness cartilage defect of the knee repaired by step cooling cryopreserved osteochondral allograft is satisfactory in short-time follow-up.