Ozmeriç Ahmet, Alemdaroğlu Kadir Bahadır, Aydoğan Nevres Hürriyet
Ahmet Özmeriç, Kadir Bahadır Alemdaroğlu, Nevres Hürriyet Aydoğan, Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, 06340 Ankara, Turkey.
World J Orthop. 2014 Nov 18;5(5):677-84. doi: 10.5312/wjo.v5.i5.677.
Treatment of articular cartilage injuries to the knee remains a considerable challenge today. Current procedures succeed in providing relief of symptoms, however damaged articular tissue is not replaced with new tissue of the same biomechanical properties and long-term durability as normal hyaline cartilage. Despite many arthroscopic procedures that often manage to achieve these goals, results are far from perfect and there is no agreement on which of these procedures are appropriate, particularly when full-thickness chondral defects are considered.Therefore, the search for biological solution in long-term functional healing and increasing the quality of wounded cartilage has been continuing. For achieving this goal and apply in wide defects, scaffolds are developed.The rationale of using a scaffold is to create an environment with biodegradable polymers for the in vitro growth of living cells and their subsequent implantation into the lesion area. Previously a few numbers of surgical treatment algorithm was described in reports, however none of them contained one-step or two -steps scaffolds. The ultimate aim of this article was to review various arthroscopic treatment options for different stage lesions and develop a new treatment algorithm which included the scaffolds.
如今,膝关节软骨损伤的治疗仍然是一项巨大的挑战。目前的治疗方法能够成功缓解症状,然而受损的关节组织并不能被具有与正常透明软骨相同生物力学特性和长期耐久性的新组织所替代。尽管许多关节镜手术常常能够实现这些目标,但结果远非完美,对于哪些手术方法合适,尤其是在考虑全层软骨缺损时,尚无定论。因此,人们一直在寻找能够实现长期功能愈合并提高受损软骨质量的生物学解决方案。为了实现这一目标并应用于大面积缺损,人们开发了支架。使用支架的基本原理是利用可生物降解聚合物创造一个环境,用于活细胞的体外生长以及随后将其植入损伤区域。此前的报告中描述了一些手术治疗方案,但其中都没有包含一步或两步式支架。本文的最终目的是回顾针对不同阶段损伤的各种关节镜治疗选择,并开发一种包含支架的新治疗方案。