Department of Orthopaedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2014 Jun;22(6):1270-6. doi: 10.1007/s00167-013-2747-x. Epub 2013 Nov 7.
Articular cartilage defects of the knee are a common condition for which several repair techniques have been described. The aim of the present study was to assess medium-term results of a one-step procedure using a cell-free collagen type I matrix.
Fifteen patients with articular cartilage defects of the knee were treated with an 11-mm-diameter cell-free collagen type 1 matrix implant. The matrices were implanted in a press-fit manner into the defect after careful debridement down to the subchondral bone but without penetration of this margin. Follow-up examinations were carried out at 6 weeks, 6 months, and at 12, 24, 36, and 48 months after implantation. Clinical assessment included the visual analogue scale (VAS), the Tegner activity scale, and the International Knee Documentation Committee (IKDC) score. Radiological assessment for graft attachment and tissue regeneration was performed using the magnetic observation of cartilage repair tissue (MOCART) score.
A total of 15 patients (males: n = 6 and females: n = 9) with a mean age of 26.4 years (range 19-40) were treated. The mean VAS improved significantly when compared to the preoperative values (P < 0.05). Six weeks after implantation, IKDC values were slightly lower than the preoperative values (n.s.), but increased significantly at final follow-up (P < 0.05). At 24 months, there were no significant differences in the median Tegner score between the post-operative values and the preoperative values (n.s.). However, after 36 months, a significant improvement was noted that lasted at least up to 48 months (P < 0.05). The MOCART score improved consistently up to 4 years after implantation, with significant improvements already observed after 12 months (P < 0.05). No correlation between the clinical scores and the MOCART score could be perceived.
The present study showed that the use of cell-free collagen type I matrix implants led to a significant and durable improvement in all the clinical and imaging scores investigated 4 years after implantation.
IV.
膝关节关节软骨缺损是一种常见病症，已经描述了几种修复技术。本研究的目的是评估使用无细胞胶原 I 型基质的一步法的中期结果。
15 例膝关节关节软骨缺损患者采用 11mm 直径无细胞胶原 1 型基质植入物治疗。在仔细清创至软骨下骨但不穿透此边缘后，将基质以压配方式植入缺损处。植入后 6 周、6 个月以及 12、24、36 和 48 个月进行随访检查。临床评估包括视觉模拟评分（VAS）、Tegner 活动量表和国际膝关节文献委员会（IKDC）评分。使用磁共振观察软骨修复组织（MOCART）评分评估移植物附着和组织再生的放射学评估。
共治疗 15 例患者（男性：n=6 例，女性：n=9 例），平均年龄 26.4 岁（19-40 岁）。与术前相比，VAS 评分显著改善（P<0.05）。植入后 6 周，IKDC 值略低于术前值（无统计学意义），但在最终随访时显著增加（P<0.05）。24 个月时，术后和术前的中位数 Tegner 评分无显著差异（无统计学意义）。然而，36 个月后，观察到显著改善，至少持续到 48 个月（P<0.05）。MOCART 评分在植入后 4 年内持续改善，植入后 12 个月即有显著改善（P<0.05）。临床评分与 MOCART 评分之间无相关性。
本研究表明，使用无细胞胶原 I 型基质植入物可显著改善所有临床和影像学评分，在植入后 4 年仍可获得持久的改善。
IV。
