Fritz J, Gaissmaier C, Schewe B, Weise K
Berufsgenossenschaftliche Unfallklinik Tübingen, Schnarrenbergstrasse 95, 72076 Tübingen.
Unfallchirurg. 2006 Jul;109(7):563-74; quiz 575-6. doi: 10.1007/s00113-006-1121-6.
Full thickness defects of the articular cartilage in the knee joint have lower regenerative properties compared to chondral lesions of the ankle. In order to avoid early osteoarthritis, symptomatic articular cartilage defects in younger patients should undergo biological reconstruction as early as possible. There are different surgical procedures available to achieve a biological resurfacing of the articular joint line. Numerous animal experiments and clinical studies have shown that early biological reconstruction of circumscribed cartilage defects in the knee is superior to a conservative or delayed operative treatment. This effect refers not only to the defect healing but also to the elimination of changes following secondary osteoarthritis. The different surgical procedures can be differentiated concerning the various indications and the final outcome. Additional malalignment, meniscus tears, and/or ligament instabilities should be treated simultaneously together with the cartilage resurfacing. The mid- and long-term results of the different current techniques are promising, but further modifications and improvements are needed.
与踝关节软骨损伤相比，膝关节全层关节软骨缺损的再生能力较低。为避免早期骨关节炎，年轻患者有症状的关节软骨缺损应尽早进行生物重建。有多种手术方法可实现关节线的生物表面重建。大量动物实验和临床研究表明，膝关节局限性软骨缺损的早期生物重建优于保守治疗或延迟手术治疗。这种效果不仅体现在缺损愈合方面，还体现在继发性骨关节炎后变化的消除上。不同的手术方法可根据各种适应症和最终结果进行区分。额外的对线不良、半月板撕裂和/或韧带不稳定应与软骨表面重建同时进行治疗。目前不同技术的中长期结果很有前景，但仍需要进一步的改进和完善。
