Krueger David R, Gesslein Markus, Schuetz Michael, Perka Carsten, Schroeder Joerg H
Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin, Germany.
Department of Trauma and Orthopaedic Surgery, Paracelsus Medical University, Breslauer Straße 201, Nuremberg, Germany.
J Hip Preserv Surg. 2018 Dec 4;5(4):386-392. doi: 10.1093/jhps/hny043. eCollection 2018 Dec.
To evaluate the clinical outcome after arthroscopic matrix-associated injectable autologous chondrocyte implantation (ACI) in patients with large full-thickness acetabular cartilage defects. ACI was performed in young patients with full-thickness acetabular cartilage defects ≥2 cm in a two-step arthroscopic procedure. The patients were followed closely with clinical examinations and pre- and postoperative scores. The modified Harris Hip Score (mHHS), iHOT33 questionnaire (iHOT33) and the Subjective Hip Value (SHV) were surveyed. Demographic patient data was evaluated for influencing factors for the pre- and postoperative results. Thirty-two consecutive cases (4 female, 28 male, mean age 33 years) were included. The average defect size was 4.9 (range: 2-6) cm. They were followed at 6, 12, 24 and 36 months postoperatively. Patients had improved significantly from 64 to 91 points ( < 0.001) in the mHHS, from 44% to 86% ( < 0.001) in the iHOT33 and from 54% to 87% ( < 0.001) in the SHV. No surgery related complications were noted. Cell cultivation failed in two cases (7%) and the patients decided for a repeated harvesting of cartilage cylinders followed by a successful ACI. Patients age and size of the cartilage defect showed no significant correlation with the pre- or postoperative results. Injectable ACI is a reliable procedure treating full-thickness acetabular cartilage defects leading to promising results 3 years postoperatively with a significant increase in all scores despite large acetabular cartilage defects in the weight-bearing zone.
评估关节镜下基质相关可注射自体软骨细胞植入术（ACI）治疗大面积全层髋臼软骨缺损患者的临床疗效。对髋臼全层软骨缺损≥2 cm的年轻患者采用两步关节镜手术进行ACI治疗。通过临床检查及术前、术后评分对患者进行密切随访。采用改良Harris髋关节评分（mHHS）、iHOT33问卷（iHOT33）和主观髋关节评分（SHV）进行调查。评估患者人口统计学数据对术前和术后结果的影响因素。纳入连续32例患者（4例女性，28例男性，平均年龄33岁）。平均缺损大小为4.9（范围：2 - 6）cm。术后6、12、24和36个月对患者进行随访。患者的mHHS评分从64分显著提高至91分（<0.001），iHOT33评分从44%提高至86%（<0.001），SHV评分从54%提高至87%（<0.001）。未发现与手术相关的并发症。2例（7%）患者细胞培养失败，患者决定再次采集软骨柱，随后成功进行了ACI治疗。患者年龄和软骨缺损大小与术前或术后结果无显著相关性。可注射ACI是治疗全层髋臼软骨缺损的可靠方法，尽管负重区髋臼软骨缺损较大，但术后3年仍取得了良好的效果，所有评分均显著提高。
