Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Am J Sports Med. 2010 Jun;38(6):1110-6. doi: 10.1177/0363546509359067. Epub 2010 Apr 14.
First-generation autologous chondrocyte implantation has limitations, and introducing new effective cell sources can improve cartilage repair.
This study was conducted to compare the clinical outcomes of patients treated with first-generation autologous chondrocyte implantation to patients treated with autologous bone marrow-derived mesenchymal stem cells (BMSCs).
Cohort study; Level of evidence, 3.
Seventy-two matched (lesion site and age) patients underwent cartilage repair using chondrocytes (n = 36) or BMSCs (n = 36). Clinical outcomes were measured before operation and 3, 6, 9, 12, 18, and 24 months after operation using the International Cartilage Repair Society (ICRS) Cartilage Injury Evaluation Package, which included questions from the Short-Form Health Survey, International Knee Documentation Committee (IKDC) subjective knee evaluation form, Lysholm knee scale, and Tegner activity level scale.
There was significant improvement in the patients' quality of life (physical and mental components of the Short Form-36 questionnaire included in the ICRS package) after cartilage repair in both groups (autologous chondrocyte implantation and BMSCs). However, there was no difference between the BMSC and the autologous chondrocyte implantation group in terms of clinical outcomes except for Physical Role Functioning, with a greater improvement over time in the BMSC group (P = .044 for interaction effect). The IKDC subjective knee evaluation (P = .861), Lysholm (P = .627), and Tegner (P = .200) scores did not show any significant difference between groups over time. However, in general, men showed significantly better improvements than women. Patients younger than 45 years of age scored significantly better than patients older than 45 years in the autologous chondrocyte implantation group, but age did not make a difference in outcomes in the BMSC group.
Using BMSCs in cartilage repair is as effective as chondrocytes for articular cartilage repair. In addition, it required 1 less knee surgery, reduced costs, and minimized donor-site morbidity.
第一代自体软骨细胞移植有其局限性，引入新的有效细胞来源可以改善软骨修复。
本研究旨在比较第一代自体软骨细胞移植与自体骨髓间充质干细胞（BMSCs）治疗患者的临床疗效。
队列研究；证据水平，3 级。
72 例（病变部位和年龄匹配）患者接受软骨细胞（n=36）或 BMSCs（n=36）进行软骨修复。采用国际软骨修复协会（ICRS）软骨损伤评估方案，在术前及术后 3、6、9、12、18 和 24 个月测量临床结果，该方案包括来自简短健康调查问卷、国际膝关节文献委员会（IKDC）主观膝关节评估表、Lysholm 膝关节量表和 Tegner 活动水平量表的问题。
两组（自体软骨细胞移植和 BMSCs）患者的生活质量（ICRS 方案中包含的简短形式 36 问卷的身体和精神成分）在软骨修复后均有显著改善。然而，除了身体角色功能外，BMSC 组的临床结果与自体软骨细胞移植组之间没有差异，且随着时间的推移，BMSC 组的改善更大（交互作用效应 P=0.044）。IKDC 主观膝关节评估（P=0.861）、Lysholm（P=0.627）和 Tegner（P=0.200）评分在组间随时间推移均无显著差异。然而，一般来说，男性的改善明显优于女性。在自体软骨细胞移植组中，年龄小于 45 岁的患者比年龄大于 45 岁的患者评分显著更好，但在 BMSC 组中，年龄对结果没有影响。
在软骨修复中使用 BMSCs 与使用软骨细胞一样有效，可修复关节软骨。此外，它需要进行 1 次膝关节手术，降低了成本，最大限度地减少了供体部位的发病率。
