Vijayan S, Bentley G, Briggs Twr, Skinner Ja, Carrington Rwj, Pollock R, Flanagan Am
Joint Reconstruction and Cartilage Transplantation Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, United Kingdom.
Indian J Orthop. 2010 Jul;44(3):238-45. doi: 10.4103/0019-5413.65136.
Articular cartilage damage in the young adult knee, if left untreated, it may proceed to degenerative osteoarthritis and is a serious cause of disability and loss of function. Surgical cartilage repair of an osteochondral defect can give the patient significant relief from symptoms and preserve the functional life of the joint. Several techniques including bone marrow stimulation, cartilage tissue based therapy, cartilage cell seeded therapies and osteotomies have been described in the literature with varying results. Established techniques rely mainly on the formation of fibro-cartilage, which has been shown to degenerate over time due to shear forces. The implantation of autologous cultured chondrocytes into an osteochondral defect, may replace damaged cartilage with hyaline or hyaline-like cartilage. This clinical review assesses current surgical techniques and makes recommendations on the most appropriate method of cartilage repair when managing symptomatic osteochondral defects of the knee. We also discuss the experience with the technique of autologous chondrocyte implantation at our institution over the past 11 years.
年轻成人膝关节的关节软骨损伤若不治疗，可能会发展为退行性骨关节炎，是导致残疾和功能丧失的严重原因。骨软骨缺损的手术软骨修复可显著缓解患者症状并保留关节的功能寿命。文献中描述了多种技术，包括骨髓刺激、基于软骨组织的治疗、软骨细胞种植治疗和截骨术，结果各不相同。现有技术主要依赖纤维软骨的形成，而纤维软骨已被证明会因剪切力随时间退化。将自体培养的软骨细胞植入骨软骨缺损处，可能会用透明软骨或类似透明软骨的组织替代受损软骨。本临床综述评估了当前的手术技术，并就处理膝关节有症状的骨软骨缺损时最合适的软骨修复方法提出建议。我们还讨论了过去11年我们机构在自体软骨细胞植入技术方面的经验。
