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比较壳聚糖基液体支架和透明质酸基软支架全关节镜植入治疗膝髁骨软骨病变。

Comparison of All Arthroscopic Implantation of Chitosan-Based Liquid Scaffold and Hyaluronan-Based Soft Scaffold in the Treatment of Condylar Osteochondral Lesions in the Knee.

机构信息

Department of Orthopedics and Traumatology, Ankara University, Ankara, Turkey.

Department of Histology and Embryology, Ankara University, Ankara, Turkey.

出版信息

J Knee Surg. 2022 Jan;35(2):222-230. doi: 10.1055/s-0041-1729550. Epub 2021 Apr 30.

Abstract

Cell-free scaffolds used in cartilage regeneration are produced from different materials. The aim of this study is to compare the clinical and radiological results of two different scaffolds with hyaluronan- or chitosan-based structure used in the treatment of symptomatic condylar osteochondral lesions. The study comprises 69 patients who were operated for osteochondral lesion repair with hyaluronan- ( = 37) or chitosan-based ( = 32) scaffold. The International Knee Documentation Committee (IKDC), Lysholm Knee Scoring Scale and Visual Analog Scale (VAS) scores were collected for both groups at the preoperative and postoperative 3rd, 12th, and 24th months. Magnetic resonance imaging was performed between the 12th and 15th months postoperatively and this with magnetic resonance observation of cartilage repair tissue (MOCART) scoring were compared. Within group assessments demonstrate significant improvement in IKDC, Lysholm, and VAS scores at postoperative 3rd and 12th months. However, in both groups, IKDC, Lysholm and, VAS scores at the postoperative 24th month indicate no significant further improvement, compared with the 12th month results. There was no significant difference between the groups in terms of IKDC, Lysholm, VAS, and MOCART scores at any time period. This study shows that both scaffolds are useful in cartilage regeneration but have no clinical or radiological superiority to each other. Surgeons should select the method with which they feel comfortable. This is a level III, retrospective comparative study.

摘要

用于软骨再生的无细胞支架由不同的材料制成。本研究旨在比较两种不同支架的临床和影像学结果,这两种支架分别基于透明质酸或壳聚糖结构,用于治疗有症状的髁突骨软骨病变。该研究包括 69 名接受透明质酸(n=37)或壳聚糖(n=32)支架治疗骨软骨病变修复的患者。两组患者在术前和术后第 3、12 和 24 个月分别收集国际膝关节文献委员会(IKDC)、Lysholm 膝关节评分量表和视觉模拟评分(VAS)评分。术后 12-15 个月进行磁共振成像(MRI)检查,并与磁共振软骨修复组织评估(MOCART)评分进行比较。组内评估显示,在术后第 3 和 12 个月,IKDC、Lysholm 和 VAS 评分显著改善。然而,与第 12 个月的结果相比,在第 24 个月,两组的 IKDC、Lysholm 和 VAS 评分均无明显进一步改善。在任何时间点,两组的 IKDC、Lysholm、VAS 和 MOCART 评分均无显著差异。本研究表明,两种支架在软骨再生中均有效,但彼此之间没有临床或影像学优势。外科医生应选择他们感觉舒适的方法。这是一项 III 级回顾性比较研究。

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