Saumya Orthocare: Centre for Advanced Surgeries of the Knee Joint, Ahmedabad, India.
Akhtar Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran.
Arthroscopy. 2014 Apr;30(4):497-505. doi: 10.1016/j.arthro.2013.12.023.
Our purpose was to examine the Level I and II evidence for the use of osteochondral cylinder transfer technique (OCT) for cartilage repair.
A literature search was carried out for Level I and II evidence studies on cartilage repair using the PubMed database. All the studies that involved OCT were identified. Only Level I and II studies that compared OCT to other modalities of treatment such as microfracture (MF) and autologous chondrocyte implantation (ACI) were selected.
A total of 8 studies matched the selection criteria with 2 Level I and 6 Level II studies. Four studies compared OCT with MF, 3 compared OCT with ACI, and one compared all 3 techniques. Of 3 studies, 4 came from a single center. Mean age of patients ranged from 24 to 33 years, and mean follow-up ranged from 9 to 124 months. The studies from the single center showed superior results from OCT over MF, especially in younger patients, with one study having long-term follow-up of 10 years. They also showed an earlier return to sports. The size of the lesions were small (average < 3 cm(2)). The 4 other independent studies did not show any difference between OCT and ACI, with one study showing inferior outcome in the OCT group. Magnetic resonance imaging (MRI) showed good osseous integration of the osteochondral plugs to the subchondral bone. Histologic examination showed that there was hyaline cartilage in the transplanted osteochondral plugs but no hyaline cartilage between the plugs.
From the studies of a single center, OCT had an advantage over MF in younger patients with small chondral lesions. Comparison of outcomes between OCT and ACI showed no significant difference in 2 studies and contrasting results in another 2 studies. There was insufficient evidence for long-term results for OCT.
Level II, systematic review of Level I and II studies.
本研究旨在评估使用骨软骨圆柱转移技术（OCT）进行软骨修复的 I 级和 II 级证据。
我们在 PubMed 数据库中对使用 OCT 进行软骨修复的 I 级和 II 级证据研究进行了文献检索。确定了所有涉及 OCT 的研究。仅选择了将 OCT 与微骨折（MF）和自体软骨细胞移植（ACI）等其他治疗方式进行比较的 I 级和 II 级研究。
共有 8 项研究符合选择标准，其中 2 项为 I 级研究，6 项为 II 级研究。4 项研究比较了 OCT 与 MF，3 项研究比较了 OCT 与 ACI，1 项研究比较了所有 3 种技术。其中 3 项研究来自单一中心。患者的平均年龄为 24 至 33 岁，平均随访时间为 9 至 124 个月。来自单一中心的研究显示，OCT 在年轻患者中优于 MF，尤其是在一项具有 10 年长期随访的研究中。OCT 还能更早地恢复运动。病变的大小较小（平均 < 3 cm(2)）。另外 4 项独立研究未显示 OCT 与 ACI 之间存在任何差异，其中 1 项研究显示 OCT 组的结果较差。磁共振成像（MRI）显示骨软骨塞与软骨下骨具有良好的骨性整合。组织学检查显示，移植的骨软骨塞中有透明软骨，但塞之间没有透明软骨。
来自单一中心的研究表明，在年轻患者和小的软骨病变患者中，OCT 优于 MF。OCT 与 ACI 之间的结果比较在 2 项研究中无显著差异，而在另外 2 项研究中结果相反。OCT 的长期结果证据不足。
II 级，I 级和 II 级研究的系统评价。
