Behrens P, Ehlers E M, Köchermann K U, Rohwedel J, Russlies M, Plötz W
Orthopädischen Klinik, Med. Univ. zu Lübeck.
MMW Fortschr Med. 1999 Nov 11;141(45):49-51.
Owing to the poor regenerative capacity of cartilage, cartilaginous defects are considered to represent pre-arthrotic factors. In addition to autologous and allogenic osteochondral fragments, proliferative tissue, such as periosteum and perichondrium are increasingly being used as graft material. The aim of treatment is to eliminate the defect and to restore the load-bearing capacity and function of the affected joint. A new, recently introduced, approach aims to stimulate the formation of new cartilage via autologous cultured chondrocyte implantation (ACI). The rationale for this treatment is the restoration of loadable hyaline or hyaline-like articular cartilage. Although long-term results are not yet available, clinical follow-up data obtained so far are encouraging. In addition to existing methods of treating cartilaginous defects, this article describes a modified method of transplantation of autologous chondrocytes. With this method the periosteal flap used to cover a defect is replaced by an absorbable collagenl/III membrane (Chondrogide, Geistlich Wolhusen, Switzerland) that is used as a carrier for the patient's own chondrocytes. After placement in the defect, the membrane is fixed in place with fibrin glue (MACI).
由于软骨的再生能力较差，软骨缺损被认为是关节病变前期的因素。除了自体和异体骨软骨碎片外，增殖性组织，如骨膜和软骨膜越来越多地被用作移植材料。治疗的目的是消除缺损并恢复受影响关节的承重能力和功能。一种新的、最近引入的方法旨在通过自体培养软骨细胞植入（ACI）刺激新软骨的形成。这种治疗方法的基本原理是恢复可承受负荷的透明软骨或类透明软骨样关节软骨。尽管尚未获得长期结果，但迄今为止获得的临床随访数据令人鼓舞。除了现有的治疗软骨缺损的方法外，本文还描述了一种改良的自体软骨细胞移植方法。使用这种方法时，用于覆盖缺损的骨膜瓣被一种可吸收的胶原I/III膜（Chondrogide，Geistlich Wolhusen，瑞士）所取代，该膜用作患者自身软骨细胞的载体。放置在缺损处后，用纤维蛋白胶（MACI）将膜固定到位。
