Department of Orthopedic Sports Medicine and Arthroscopic Surgery, Hessing Stiftung, Augsburg, Germany; Clinic and Policlinic for Orthopedic Surgery, University Rostock, Rostock, Germany.
Department of Orthopedic Sports Medicine and Arthroscopic Surgery, Hessing Stiftung, Augsburg, Germany.
Arthroscopy. 2021 Jun;37(6):1892-1899.e1. doi: 10.1016/j.arthro.2021.01.038. Epub 2021 Feb 1.
To evaluate subjective and objective clinical and magnetic resonance imaging-based radiologic outcomes after short-term follow-up in patients with focal full-size cartilage lesions of the knee joint treated with all-arthroscopic hydrogel-based autologous chondrocyte transplantation.
A retrospective study on patients with isolated focal cartilage defects of the knee joint who were treated with arthroscopically conducted matrix-induced autologous chondrocyte transplantation was performed. Clinical scores were assessed at baseline and final follow-up using the Tegner Score, visual analog scale, the International Knee Documentation Committee, and the 5 subscales of the Knee Injury and Osteoarthritis Outcome Score. Magnetic resonance imaging scans of the treated knee joints were evaluated with the updated MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 scoring system at follow-up.
Twenty-nine consecutive patients were included in the study. Mean time to follow-up was 24.9 ± 1.1 months. Average visual analog scale decreased significantly from 6.5 ± 3.1 preoperatively to 2.3 ± 1.6 at follow-up (P < .0001). Tegner score increased from 3.1 ± 1.3 to 4.3 ± 1.2 (P < .0001) and the International Knee Documentation Committee from 43.8 ± 21.9 to 64.9 ± 18.9 (P < .0001). Also, all Knee Injury and Osteoarthritis Outcome Score subscales displayed significant improvements. Patients showed similar improvements of nearly all clinical scores independent of the defect size. Average MOCART2.0 score was 70.0 ± 13.6 and 20 patients scored ≥70 points. All 8 patients with large defects (>5 cm) scored ≥75 points.
In this small study, injectable matrix-induced autologous chondrocyte transplantation therapy in the knee joint led to favourable clinical and radiologic short-term results with significant improvements in all clinical scores and MOCART2.0 scores, confirming morphologic integrity of the transplanted chondrocytes. Therefore, this minimally invasive procedure represents a promising operative technique for cartilage regeneration, even for large-diameter lesions.
IV, therapeutic case series.
评估膝关节局灶性全层软骨病变患者行全关节镜下基于水凝胶的自体软骨细胞移植后的短期随访时的主观和客观临床及磁共振成像（MRI）基于放射学的结果。
对接受关节镜下基质诱导的自体软骨细胞移植治疗的膝关节局灶性孤立性软骨缺损患者进行回顾性研究。在基线和最终随访时，使用 Tegner 评分、视觉模拟评分（VAS）、国际膝关节文献委员会（IKDC）评分和膝关节损伤和骨关节炎结果评分（KOOS）的 5 个亚量表评估临床评分。采用改良的 MRI 软骨修复组织（MOCART）2.0 评分系统评估治疗膝关节的 MRI 扫描，并在随访时进行评估。
本研究共纳入 29 例连续患者。平均随访时间为 24.9 ± 1.1 个月。平均 VAS 从术前的 6.5 ± 3.1 显著降低至随访时的 2.3 ± 1.6（P <.0001）。Tegner 评分从 3.1 ± 1.3 增加到 4.3 ± 1.2（P <.0001），IKDC 评分从 43.8 ± 21.9 增加到 64.9 ± 18.9（P <.0001）。此外，所有 KOOS 亚量表均显示出显著改善。患者在几乎所有临床评分方面均表现出相似的改善，而与缺陷大小无关。平均 MOCART2.0 评分为 70.0 ± 13.6，20 例患者评分≥70 分。8 例大缺损（>5 cm）患者的评分均≥75 分。
在这项小型研究中，膝关节内注射基质诱导的自体软骨细胞移植治疗导致了良好的短期临床和放射学结果，所有临床评分和 MOCART2.0 评分均显著改善，证实了移植软骨细胞的形态完整性。因此，这种微创技术是一种有前途的软骨再生手术技术，即使是大直径病变也是如此。
IV，治疗性病例系列。
