I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
Adv Exp Med Biol. 2018;1058:359-372. doi: 10.1007/978-3-319-76711-6_16.
Mesenchymal stem cells (MSCs) are pluripotent stem cells with the ability to differentiate into a variety of other connective tissue cells, such as chondral, bony, muscular, and tendon tissue. Bone marrow-derived MSCs are pluripotent cells that can differentiate among others into osteoblasts, adipocytes and chondrocytes.Bone marrow-derived cells may represent the future in osteochondral repair. A one-step arthroscopic technique is developed for cartilage repair, using a device to concentrate bone marrow-derived cells and collagen powder or hyaluronic acid membrane as scaffolds for cell support and platelet gel.The rationale of the "one-step technique" is to transplant the entire bone-marrow cellular pool instead of isolated and expanded mesenchymal stem cells allowing cells to be processed directly in the operating room, without the need for a laboratory phase. For an entirely arthroscopic implantation are employed a scaffold and the instrumentation previously applied for ACI; in addition to these devices, autologous platelet-rich fibrin (PRF) is added in order to provide a supplement of growth factors. Results of this technique are encouraging at mid-term although long-term follow-up is still needed.
间充质干细胞（MSCs）是多能干细胞，具有分化为多种其他结缔组织细胞的能力，如软骨、骨、肌肉和肌腱组织。骨髓来源的间充质干细胞是多能细胞，可以分化为成骨细胞、脂肪细胞和成软骨细胞。骨髓来源的细胞可能代表着骨软骨修复的未来。已经开发出一种用于软骨修复的一步关节镜技术，使用一种装置浓缩骨髓来源的细胞和胶原粉末或透明质酸膜作为细胞支持和血小板凝胶的支架。“一步技术”的原理是移植整个骨髓细胞库，而不是分离和扩增间充质干细胞，允许细胞在手术室直接进行处理，而无需实验室阶段。对于完全关节镜植入，使用了先前用于 ACI 的支架和仪器；除了这些设备外，还添加了自体富血小板纤维蛋白（PRF）以提供生长因子的补充。尽管仍需要长期随访，但该技术的中期结果令人鼓舞。
