Buda Roberto, Vannini Francesca, Cavallo Marco, Baldassarri Matteo, Natali Simone, Castagnini Francesco, Giannini Sandro
1 Orthopaedics and Traumatology Clinic, Rizzoli Orthopaedics Institute, Bologna, Italy.
Joints. 2014 Jan 8;1(3):102-7. eCollection 2013 Jul-Sep.
PURPOSE: to verify the capability of scaffold-supported bone marrow-derived cells to be used in the repair of osteochondral lesions of the talus. METHODS: using a device to concentrate bone marrow-derived cells, a scaffold (collagen powder or hyaluronic acid membrane) for cell support and platelet gel, a one-step arthroscopic technique was developed for cartilage repair. In a prospective clinical study, we investigated the ability of this technique to repair talar osteochondral lesions in 64 patients. The mean follow-up was 53 months. Clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scale score. We also considered the influence of scaffold type, lesion area, previous surgery, and lesion depth. RESULTS: the mean preoperative AOFAS scale score was 65.2 ± 13.9. The clinical results peaked at 24 months, before declining gradually to settle at a score of around 80 at the maximum follow-up of 72 months. CONCLUSIONS: the use of bone marrow-derived cells supported by scaffolds to repair osteochondral lesions of the talus resulted in significant clinical improvement, which was maintained over time. LEVEL OF EVIDENCE: level IV, therapeutic case series.
目的：验证支架支持的骨髓源性细胞用于修复距骨骨软骨损伤的能力。 方法：使用一种浓缩骨髓源性细胞的装置、一种用于细胞支持的支架（胶原粉或透明质酸膜）和血小板凝胶，开发了一种用于软骨修复的一步关节镜技术。在一项前瞻性临床研究中，我们调查了该技术修复64例患者距骨骨软骨损伤的能力。平均随访时间为53个月。使用美国矫形足踝协会（AOFAS）量表评分评估临床结果。我们还考虑了支架类型、损伤面积、既往手术和损伤深度的影响。 结果：术前AOFAS量表平均评分为65.2±13.9。临床结果在24个月时达到峰值，随后逐渐下降，在最长72个月的随访时稳定在80分左右。 结论：使用支架支持的骨髓源性细胞修复距骨骨软骨损伤可带来显著的临床改善，且这种改善随时间得以维持。 证据水平：IV级，治疗性病例系列。
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