Banke I J, Vogt S, Buchmann S, Imhoff A B
Abteilung und Poliklinik für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Deutschland.
Orthopade. 2011 Jan;40(1):85-92. doi: 10.1007/s00132-010-1682-5.
Chondral or osteochondral lesions of the shoulder may lead to premature osteoarthritis of the glenohumeral joint as regeneration of damaged articular cartilage is lacking. Rising health awareness, increasingly active populations and improvements in medical techniques have increased the application of cartilage regenerative minimally invasive approaches for glenohumeral joint preservation or delayed prosthetic replacement. In contrast to the conclusive and mostly convincing mid-term results of cartilage regenerative techniques known for the knee, clinical results of innovative therapeutic approaches with glenohumeral cartilage defects are more or less absent. Current techniques include procedures for mesenchymal stem cell recruitment, such as microfracturing, (autologous) osteochondral transplantation, (matrix-associated) autologous chondrocyte transplantation and biological resurfacing, addressing focal chondral defects up to massive structural osteochondral defects. With increasing arthroscopic applicability, they evolve to important tools in the armamentarium of the shoulder surgeon. Future clinical data will determine evidence-based applicability, enabling standardized treatment selection.
肩部软骨或骨软骨损伤可能会导致盂肱关节过早出现骨关节炎，因为受损的关节软骨缺乏再生能力。人们健康意识的提高、人口日益活跃以及医疗技术的进步，增加了软骨再生微创方法在盂肱关节保存或延迟假体置换方面的应用。与膝关节已知的软骨再生技术确凿且大多令人信服的中期结果相比，针对盂肱软骨缺损的创新治疗方法几乎没有临床结果。目前的技术包括间充质干细胞募集程序，如微骨折术、（自体）骨软骨移植、（基质相关）自体软骨细胞移植和生物表面重建，可解决局部软骨缺损直至大面积结构性骨软骨缺损。随着关节镜适用性的提高，它们逐渐成为肩部外科医生工具库中的重要工具。未来的临床数据将确定基于证据的适用性，从而实现标准化的治疗选择。
