Department of Trauma Surgery, University Hospital Regensburg, Franz Josef Strauss Allee 11, 93042 Regensburg, Germany.
Arch Orthop Trauma Surg. 2012 Jun;132(6):855-60. doi: 10.1007/s00402-012-1477-8. Epub 2012 Feb 19.
The treatment of large full thickness cartilage defects with matrix guided autologous chondrocyte transplantation shows promising results. However, in many cases an arthrotomy is needed to implant the cell seeded scaffolds. Recently techniques have been developed for arthroscopically guided ACT implantation. Correct defect mapping, to assess size and depth of the chondral lesions, and precise scaffold preparation and fixation are crucial for successful chondrocyte transplantation and remain to be not sufficiently optimized.
In the present study, the geometries of two cartilage defects in cadaver knees were three times assessed, measured and transferred to biodegradable scaffolds with a navigation system by three different executors. The scaffolds were arthroscopically implanted into the cartilage defects.
The cartilage defect assessment was reproducible between all executors for all defect geometries. The implanted scaffolds showed a correct defect filling.
The study showed the feasibility of an arthroscopic implantation of scaffolds for autologous chondrocytes transplantation. Navigation was a useful tool to exactly assess the cartilage defect geometry and allowed a precise transfer of navigated cartilage defect geometries for individualized scaffold preparation. Navigation can help to accomplish and optimize arthroscopically guided chondrocyte transplantations.
采用基质引导的自体软骨细胞移植治疗大面积全层软骨缺损显示出良好的效果。然而，在许多情况下，需要进行关节切开术来植入细胞接种支架。最近，已经开发出了用于关节镜引导 ACT 植入的技术。正确的缺陷绘图，以评估软骨损伤的大小和深度，以及精确的支架制备和固定，对于成功的软骨细胞移植至关重要，但仍未得到充分优化。
在本研究中，通过导航系统，由三位不同的执行者对尸体膝关节中的两个软骨缺损进行了三次评估、测量和转移到生物可降解支架上。然后将这些支架关节镜下植入软骨缺损处。
对于所有的缺陷几何形状，所有执行者之间的软骨缺陷评估都是可重复的。植入的支架显示出正确的缺陷填充。
该研究表明，使用导航辅助的关节镜下植入支架进行自体软骨细胞移植是可行的。导航是一种有用的工具，可以精确地评估软骨缺陷的几何形状，并允许对导航后的软骨缺陷几何形状进行精确的转移，以进行个体化的支架制备。导航可以帮助完成和优化关节镜引导的软骨细胞移植。
