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用于膝关节全层软骨缺损修复的 ChonDux 水凝胶的两年随访及重塑动力学研究。

Two-Year Follow-Up and Remodeling Kinetics of ChonDux Hydrogel for Full-Thickness Cartilage Defect Repair in the Knee.

机构信息

Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Cartilage. 2020 Oct;11(4):447-457. doi: 10.1177/1947603518800547. Epub 2018 Oct 3.

Abstract

OBJECTIVE

To determine performance and repair kinetics of the ChonDux hydrogel scaffold for treating focal articular cartilage defects in the knee over 24 months.

DESIGN

This assessor-blinded trial evaluates ChonDux hydrogel scaffold implantation in combination with microfracture in 18 patients across 6 sites. Male and female patients 18 to 65 years of age with full-thickness femoral condyle defects 2 to 4 cm in area were enrolled. Eligible patients received ChonDux treatment followed by rehabilitation. Defect volume fill was evaluated after 3, 6 (primary outcome), 12, 18, and 24 months by assessor blinded magnetic resonance imaging (MRI) analysis. Secondary outcomes were T2-weighted MRI relaxation time and patient surveys via visual analogue scale (VAS) pain and International Knee Documentation Committee (IKDC) knee function scoring.

RESULTS

ChonDux maintained durable tissue restoration over 24 months with final defect percent fill of 94.2% ± 16.3% and no significant loss of fill volume at any time points. Tissues treated with ChonDux maintained T2 relaxation times similar to uninjured cartilage between 12 and 24 months. VAS pain scoring decreased between 1 and 6 weeks, and IKDC knee function scores improved by approximately 30.1 with ChonDux over 24 months.

CONCLUSION

ChonDux treatment is a safe adjunct to microfracture therapy and promotes stable restoration of full thickness articular cartilage defects for at least 24 months.

摘要

目的

确定 ChonDux 水凝胶支架在治疗膝关节局灶性关节软骨缺损方面的性能和修复动力学,时间跨度为 24 个月。

设计

这项评估者盲法试验评估了 ChonDux 水凝胶支架在 6 个部位的 18 名患者中与微骨折联合应用的效果。18 名 18 至 65 岁的男性和女性患者,其股骨髁全层缺陷面积为 2 至 4 厘米,均符合入组条件。合格的患者接受 ChonDux 治疗后再进行康复。通过评估者盲法磁共振成像(MRI)分析,在 3、6(主要终点)、12、18 和 24 个月时评估缺陷体积填充情况。次要结局为 T2 加权 MRI 弛豫时间以及通过视觉模拟量表(VAS)疼痛和国际膝关节文献委员会(IKDC)膝关节功能评分进行的患者调查。

结果

ChonDux 在 24 个月内保持了持久的组织修复,最终缺陷百分比填充率为 94.2%±16.3%,在任何时间点均无填充体积显著丢失。ChonDux 治疗的组织在 12 至 24 个月之间保持与未受伤软骨相似的 T2 弛豫时间。VAS 疼痛评分在 1 至 6 周之间下降,而 IKDC 膝关节功能评分在 24 个月内提高了约 30.1。

结论

ChonDux 治疗是微骨折治疗的一种安全辅助手段,可促进全层关节软骨缺损的稳定修复,至少持续 24 个月。

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