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关节镜下基质包裹自体软骨细胞移植:拉丁美洲多中心初步研究。

Arthroscopic Matrix-Encapsulated Autologous Chondrocyte Implantation: A Pilot Multicenter Investigation in Latin America.

机构信息

Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, DF, Mexico.

School of Medicine, Universidad Panamericana, Mexico City, Benito Juarez, Mexico.

出版信息

Cartilage. 2021 Dec;13(1_suppl):1074S-1084S. doi: 10.1177/1947603520918630. Epub 2020 May 14.

Abstract

. To evaluate minimum biosecurity parameters (MBP) for arthroscopic matrix-encapsulated autologous chondrocyte implantation (AMECI) based on patients' clinical outcomes, magnetic resonance imaging (MRI) T2-mapping, Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, and International Cartilage Repair Society (ICRS) second-look arthroscopic evaluation, laying the basis for a future multicenter study. . Pilot clinical study. We analyzed the logistics to perform AMECI to treat focal chondral lesions in different hospitals following strict biosecurity parameters related to tissue and construct transportation, chondrocyte isolation, and cell expansion. Patient progress was analyzed with patient-reported outcome measures, MRI T2-mapping, MOCART, and ICRS arthroscopic second-look evaluation. . Thirty-five lesions in 30 patients treated in 7 different hospitals were evaluated. Cell viability before implantation was >90%. Cell viability in construct remnants was 87% ± 11% at 24 hours, 75% ± 17.1% at 48 hours, and 60% ± 8% at 72 hours after implantation. Mean final follow-up was 37 months (12-72 months). Patients showed statistically significant improvement in all clinical scores and MOCART evaluations. MRI T2-mapping evaluation showed significant decrease in relaxation time from 61.2 ± 14.3 to 42.9 ± 7.2 ms ( < 0.05). Arthroscopic second-look evaluation showed grade II "near normal" tissue in 83% of patients. Two treatment failures were documented. . It was feasible to perform AMECI in 7 different institutions in a large metropolitan area following our biosecurity measures without any implant-related complication. Treated patients showed improvement in clinical, MRI T2-mapping, and MOCART scores, as well as a low failure rate and a favorable ICRS arthroscopic evaluation at a mid-term follow-up. . 2b.

摘要

为了评估基于患者临床结果、磁共振成像 (MRI) T2 映射、磁共振观察软骨修复组织 (MOCART) 评分和国际软骨修复学会 (ICRS) 关节镜二次评估的关节镜下基质包封自体软骨细胞移植 (AMECI) 的最低生物安全参数 (MBP),为未来的多中心研究奠定基础。 初步临床研究。 我们分析了在不同医院进行 AMECI 以治疗局灶性软骨病变的物流,这些医院遵循与组织和构建物运输、软骨细胞分离和细胞扩增相关的严格生物安全参数。 通过患者报告的结果测量、MRI T2 映射、MOCART 和 ICRS 关节镜二次评估分析患者的进展。 对 7 家不同医院治疗的 30 名患者的 35 个病变进行了评估。 植入前细胞活力>90%。 植入后 24 小时、48 小时和 72 小时,构建物残余物中的细胞活力分别为 87%±11%、75%±17.1%和 60%±8%。 平均最终随访时间为 37 个月(12-72 个月)。 所有临床评分和 MOCART 评估均显示患者有统计学显著改善。 MRI T2 映射评估显示弛豫时间从 61.2±14.3 显着降低至 42.9±7.2 ms(<0.05)。 关节镜二次评估显示 83%的患者组织为 II 级“接近正常”。 记录了 2 例治疗失败。 按照我们的生物安全措施,在一个大城市地区的 7 家不同机构中进行 AMECI 是可行的,没有任何与植入物相关的并发症。 在中期随访时,接受治疗的患者在临床、MRI T2 映射和 MOCART 评分方面均有所改善,失败率较低,ICRS 关节镜评估结果良好。 2b.

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