Orthopedic Sports Medicine and Arthroscopy Division and Tissue Engineering, Cell Therapy, and Regenerative Medicine Unit, National Institute of Rehabilitation, Mexico City, Mexico; National Polytechnic Institute, Mexico City, Mexico.
Orthopedic Sports Medicine and Arthroscopy Division, National Institute of Rehabilitation, Mexico City, Mexico.
Arthroscopy. 2014 Jun;30(6):715-23. doi: 10.1016/j.arthro.2014.02.032. Epub 2014 Apr 18.
The purpose of this study was to evaluate the clinical and sequential imaging follow-up results at a mean of 36 months after an arthroscopic technique for implantation of matrix-encapsulated autologous chondrocytes for the treatment of articular cartilage lesions on the femoral condyles.
Ten patients underwent arthroscopic implantation of autologous chondrocytes seeded onto a bioabsorbable scaffold. The patients were evaluated clinically using a visual analog scale (VAS) for pain and International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores. Magnetic resonance imaging (MRI) T2-mapping and magnetic resonance observation of cartilage repair tissue (MOCART) evaluations were also performed. Second-look arthroscopic evaluation using the International Cartilage Repair Society (ICRS) grading classification was performed at 12 months.
Compared with their preoperative values, at 36 months mean values ± standard deviation for the VAS scale for pain were 6.0 ± 1.5 to 0.3 ± 0.4. Improvement in clinical scores between preoperative values and 36-month follow-up values in subjective IKDC scores was 46.9 ± 18.5 to 77.2 ± 12.8; in Lysholm scores, it was 51.8 ± 25.1 to 87.9 ± 6.5, and in the Tegner activity scale it was 2.9 ± 1.7 to 5.9 ± 1.9. Mean T2 mapping and MOCART scores improved over time to 38.1 ± 4.4 ms and 72.5 ± 10, respectively. Mean ICRS score by second-look arthroscopy at 1 year was 10.4 ± 0.1.
All clinical scores improved over time compared with the preoperative values. Clinical results are comparable with MRI T2 mapping and ICRS evaluations, suggesting that this arthroscopic technique for cell-based cartilage repair is efficacious and reproducible at a mean of 36 months of follow-up.
Level IV, therapeutic case series.
本研究旨在评估经关节镜技术植入基质包封自体软骨细胞治疗股骨髁关节软骨病变的临床和连续影像学随访结果,平均随访时间为 36 个月。
10 例患者接受了关节镜下自体软骨细胞接种于可吸收支架的植入术。患者采用视觉模拟评分(VAS)评估疼痛,国际膝关节文献委员会(IKDC)、Lysholm 和 Tegner 评分评估临床疗效。还进行了磁共振成像(MRI)T2 映射和磁共振软骨修复组织(MOCART)评估。在 12 个月时进行了国际软骨修复协会(ICRS)分级分类的二次关节镜评估。
与术前相比,36 个月时 VAS 疼痛评分的平均值±标准差从 6.0±1.5 降至 0.3±0.4。主观 IKDC 评分的临床评分从术前到 36 个月随访的改善值为 46.9±18.5 至 77.2±12.8;Lysholm 评分从 51.8±25.1 至 87.9±6.5,Tegner 活动评分从 2.9±1.7 至 5.9±1.9。平均 T2 映射和 MOCART 评分随时间推移而逐渐改善,分别达到 38.1±4.4ms 和 72.5±10。1 年时二次关节镜检查的平均 ICRS 评分为 10.4±0.1。
与术前相比,所有临床评分随时间推移均有所改善。临床结果与 MRI T2 映射和 ICRS 评估具有可比性,表明该关节镜下细胞软骨修复技术在平均 36 个月的随访中是有效且可重复的。
IV 级,治疗性病例系列。