Patil Shantanu, Tapasvi Sachin R
The Orthopaedic Speciality Clinic, 16 Status Chambers, 1221/A Wrangler Paranjpe Road, Pune, 411004, India.
Curr Rev Musculoskelet Med. 2015 Dec;8(4):423-8. doi: 10.1007/s12178-015-9299-2.
The healing potential for articular cartilage lesions is limited due to many physiological, local and mechanical factors. Spontaneous healing of partial- and full-thickness lesions is slow, and subsequent tissue response is usually not durable. In symptomatic, and high-demand, patients, a definitive treatment modality must be offered which allows for a sustained recovery with minimal debilitation. Injuries, which damage the subchondral bone, heal with the formation of fibrocartilage. This tissue fails long-term survival because of its inability to withstand the variable cyclic loads and compression forces that it is subjected to. While regeneration of the damaged cartilage by an entirely new articular surface is a goal beyond current available techniques, repair of the osteochondral defects with normal hyaline cartilage is possible by various options. Osteochondral defects that are larger then 2 cm are best treated by osteochondral autograft technique. The short-term outcomes of the present series show excellent results.
由于多种生理、局部和机械因素,关节软骨损伤的愈合潜力有限。部分厚度和全层厚度损伤的自发愈合缓慢,随后的组织反应通常也不持久。对于有症状且需求较高的患者,必须提供一种确定性的治疗方式,以实现持续恢复且衰弱最小化。损伤到软骨下骨的损伤会通过纤维软骨的形成而愈合。由于这种组织无法承受其所遭受的可变循环载荷和压缩力,因此无法长期存活。虽然通过全新的关节表面再生受损软骨是目前现有技术无法实现的目标,但通过各种方法用正常透明软骨修复骨软骨缺损是可行的。大于2厘米的骨软骨缺损最好采用骨软骨自体移植技术治疗。本系列的短期结果显示出极佳的效果。