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改良 ACI 技术治疗膝关节软骨缺损的初步结果。

The manangement of knee cartilage defects with modified amic technique: preliminary results.

机构信息

University of Molise, Department of Science for Health, Italy.

出版信息

Int J Immunopathol Pharmacol. 2011 Jan-Mar;24(1 Suppl 2):149-52. doi: 10.1177/03946320110241s228.

Abstract

Cartilage defects represent a common problem in orthopaedic practice. The knee is frequently involved and the medial femoral condyle is the most common localization. Predisposing factors are: traumas, inflammatory conditions and biomechanics alterations. Several surgical options are available once correct diagnosis is given and accurate patient evaluation has been performed. The aim of our study was to prospectively evaluate functional results of modified autologous matrix induced chondrogenesis (AMIC) technique in a population of patients affected by focal cartilage defects A population of 17 patients was enrolled in this study. 10 patients were male, mean age at the time of surgery was 39 years, right side was involved in 11 cases. All patients were evaluated with accurate physical exam and complete imaging study. At an average FU of 36 months, mean IKDC score and Lysholm score improved from 32 to 82 and from 38 to 74. 13 patients out of 17 (76.5%) were satisfied or extremely satisfied with their functional result. MRI control showed reduction of the defect area and subchondral oedema in 10 cases (58.8%). AMIC technique is a relatively new option in the treatment of full thickness cartilage lesions. It enhances the advantages of microfractures since the Chondrogide membrane protects and stabilizes the blood plug acting as a matrix for new cartilage formation. First reports on AMIC technique, show comparable results to autologous chondrocyte implantation (ACI) with the advantage of a single stage technique and no donor site morbidity. AMIC technique represents a new option in the treatment of full thickness cartilage defect. It is safe and reliable. Our data are in accordance with previously reported series in literature and confirm the good objective and subjective results of this procedure.

摘要

软骨缺损是矫形外科的常见问题。膝关节经常受累,股骨内侧髁是最常见的部位。易患因素有:创伤、炎症和生物力学改变。一旦做出正确的诊断并对患者进行了准确的评估,就可以采用几种手术方案。我们的研究目的是前瞻性评估改良自体基质诱导软骨生成(AMIC)技术在患有局灶性软骨缺损患者中的功能结果。本研究纳入了 17 例患者。10 例为男性,手术时的平均年龄为 39 岁,右侧 11 例。所有患者均接受了准确的体格检查和完整的影像学研究。在平均 36 个月的随访中,IKDC 评分和 Lysholm 评分分别从 32 分提高到 82 分和从 38 分提高到 74 分。17 例患者中有 13 例(76.5%)对其功能结果满意或非常满意。10 例(58.8%)患者的 MRI 检查显示缺损面积缩小,软骨下水肿减轻。AMIC 技术是治疗全层软骨损伤的一种较新的选择。它结合了微骨折的优点,因为软骨膜保护和稳定了血栓,起到了新软骨形成的基质作用。AMIC 技术的初步报告显示,与自体软骨细胞移植(ACI)相比,其结果相当,具有单一阶段技术和无供区并发症的优势。AMIC 技术是全层软骨缺损治疗的一种新选择。它是安全可靠的。我们的数据与文献中先前报道的系列结果一致,证实了该手术的良好客观和主观结果。

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