Goriainov Vitali, McEwan Josephine K, Oreffo Richard Oc, Dunlop Doug G
Bone & Joint Research Group, Centre for Human Development, Stem Cell & Regeneration, Institute of Developmental Sciences, University of Southampton, Tremona Road, Southampton SO16 6YD, UK.
Regen Med. 2018 Apr;13(3):283-294. doi: 10.2217/rme-2017-0127. Epub 2018 May 1.
Joint replacements have proved a medical success providing symptomatic relief and return to mobility in many patients with arthritis. However, multiple revision surgeries due to joint failure can result in complex revision scenarios with significant bone tissue loss, in an elderly population, which poses a significant clinical challenge. Computer-aided design-computer-assisted manufacturing (CAD-CAM) prototyped bespoke implants are currently being used as an alternative and innovative approach for joint restoration in salvage cases, while the incorporation of autologous skeletal stem cells to optimize regenerative capacity can enhance implant osseointegration. We present a case series of 11 patients with severe disability and significant bone loss due to failed joint replacements. The choice of CAD-CAM prototyped joint implants enhanced with autologous skeletal stem cells resulted in significant patient-reported clinical and radiological improvements.
关节置换已被证明在医学上是成功的，可为许多关节炎患者缓解症状并恢复活动能力。然而，在老年人群中，由于关节失效而进行的多次翻修手术可能会导致复杂的翻修情况，伴有大量骨组织丢失，这构成了重大的临床挑战。计算机辅助设计-计算机辅助制造（CAD-CAM）原型定制植入物目前正被用作挽救病例中关节修复的一种替代和创新方法，而引入自体骨骼干细胞以优化再生能力可增强植入物的骨整合。我们展示了一个包含11例因关节置换失败而导致严重残疾和大量骨质流失患者的病例系列。选择用自体骨骼干细胞增强的CAD-CAM原型关节植入物，在患者报告中带来了显著的临床和放射学改善。
