Braun S, Vogt S, Imhoff A B
Berufsgenossenschaftliche Unfallklinik Murnau, Prof.-Küntscher-Str. 8, 82418, Murnau am Staffelsee.
Orthopade. 2007 Jun;36(6):589-99; quiz 600. doi: 10.1007/s00132-007-1095-2.
Chondral or osteochondral lesions are typical injuries in orthopaedics and traumatology. Since there is no regeneration of damaged articular cartilage, these lesions can lead to premature osteoarthritis. Therefore, an adequate therapy for these injuries is an important goal. Nowadays, common methods in cartilage therapy are procedures for the recruitment of mesenchymal stem cells: autologous osteochondral transplantation and autologous chondrocyte transplantation. Currently, autologous osteochondral transplantation is the only procedure that allows the replacement of the defect with hyaline cartilage. However, this procedure has the problem of donor-site morbidity and limited availability of transplants. Stem cell recruiting procedures and autologous chondrocyte transplantation normally achieve a regeneration of the defect with only fibrocartilage tissue, but both can achieve good medium-term clinical results. Each of these therapeutic principles has certain major indications. In order to select an adequate therapy, the classification of chondral or osteochondral lesion is needed. From a multiplicity of classification systems, those of the ICRS are of particular clinical relevance.
软骨或骨软骨损伤是骨科和创伤学中的典型损伤。由于受损的关节软骨无法再生，这些损伤会导致过早出现骨关节炎。因此，针对这些损伤的适当治疗是一个重要目标。如今，软骨治疗的常见方法是招募间充质干细胞的程序：自体骨软骨移植和自体软骨细胞移植。目前，自体骨软骨移植是唯一能够用透明软骨替代缺损的程序。然而，该程序存在供体部位发病的问题以及移植可用性有限的问题。干细胞招募程序和自体软骨细胞移植通常仅通过纤维软骨组织实现缺损的再生，但两者都能取得良好的中期临床效果。这些治疗原则中的每一种都有特定的主要适应症。为了选择适当的治疗方法，需要对软骨或骨软骨损伤进行分类。在众多分类系统中，国际软骨修复协会（ICRS）的分类系统具有特别的临床相关性。
