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基于透明质酸的支架(Hyalograft C)治疗膝关节软骨缺损:初步临床研究结果。

Hyaluronan-based scaffolds (Hyalograft C) in the treatment of knee cartilage defects: preliminary clinical findings.

作者信息

Pavesio Alessandra, Abatangelo Giovanni, Borrione Anna, Brocchetta Domenico, Hollander Anthony P, Kon Elizaveta, Torasso Francesca, Zanasi Stefano, Marcacci Maurilio

机构信息

Fidia Advanced Biopolymers srl, Via Ponte della Fabbrica 3/B, 53031 Abano Terme, Italy.

出版信息

Novartis Found Symp. 2003;249:203-17; discussion 229-33, 234-8, 239-41.

Abstract

Hyalograft C is an innovative tissue-engineering approach for the treatment of knee cartilage defects involving the implantation of laboratory expanded autologous chondrocytes grown on a three-dimensional hyaluronan-based scaffold. This technique has recently been introduced into clinical practice, with more than 600 patients treated so far. Because no periosteal coverage is required to keep the graft in place, surgical time and morbidity are reduced, and handling of the graft is much simpler than currently available autologous chondrocyte implantation techniques. The safety profile of the treatment appears positive, with a limited number of adverse events reported. Here we discuss the clinical, arthroscopic and histological results from a cohort of 67 patients treated with Hyalograft C (mean follow-up time from implantation of 17.5 months). Results are reported based on four endpoints: patients' subjective evaluation of knee conditions (97% of patients improved) and quality of life (94% improved), surgeons' knee functional test (87% of patients with the best scores), arthroscopic evaluation of cartilage repair (96.7% biologically acceptable) and histological assessment of the grafted site (majority of specimens hyaline-like). The positive clinical results obtained indicate that Hyalograft C may be a viable therapeutic option for the treatment of acute cartilage lesions.

摘要

Hyalograft C是一种创新的组织工程方法,用于治疗膝关节软骨缺损,涉及植入在基于透明质酸的三维支架上培养的实验室扩增自体软骨细胞。该技术最近已引入临床实践,迄今为止已治疗了600多名患者。由于无需骨膜覆盖来固定移植物,手术时间和发病率降低,并且移植物的处理比目前可用的自体软骨细胞植入技术简单得多。治疗的安全性表现良好,报告的不良事件数量有限。在此,我们讨论了67例接受Hyalograft C治疗患者(植入后的平均随访时间为17.5个月)的临床、关节镜和组织学结果。结果基于四个终点报告:患者对膝关节状况的主观评估(97%的患者有所改善)和生活质量(94%有所改善)、外科医生的膝关节功能测试(87%的患者得分最佳)、关节镜对软骨修复的评估(96.7%生物学上可接受)以及移植部位的组织学评估(大多数标本呈透明样)。所获得的积极临床结果表明,Hyalograft C可能是治疗急性软骨损伤的一种可行治疗选择。

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