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富血小板纤维蛋白膜增强微骨折术修复软骨缺损的疗效优于单纯微骨折术:兔模型研究。

Autologous Platelet-Rich Fibrin Membrane to Augment Healing of Microfracture Has Better Macroscopic and Histologic Grades Compared With Microfracture Alone on Chondral Defects in a Rabbit Model.

机构信息

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

出版信息

Arthroscopy. 2022 Feb;38(2):417-426. doi: 10.1016/j.arthro.2021.04.055. Epub 2021 May 5.

Abstract

PURPOSE

To determine the in vivo effectiveness of a single-stage surgical procedure that combines microfracture and an autologous platelet-rich fibrin (PRF) membrane for cartilage repair in a rabbit model.

METHODS

Cartilage defects were created in the trochlear groove of the knees of adult white rabbits. Defects were divided into 2 treatment groups: microfracture only (control group) and microfracture covered by a PRF membrane (PRF group). To evaluate the repair cartilage, assessments were performed at 4, 12, and 24 weeks postoperatively using the International Cartilage Repair Society (ICRS) macroscopic scoring system and modified Wakitani histologic grading system.

RESULTS

The mean ICRS macroscopic scores in the control and PRF groups were 4.1 and 5.8, respectively, at 4 weeks (P = .0623); 6.3 and 9.8, respectively, at 12 weeks (P = .006); and 6.5 and 10.3, respectively, at 24 weeks (P = .010). The mean modified Wakitani scores in the control and PRF groups were 4.0 and 3.9, respectively, at 4 weeks (P > .999); 5.3 and 10.4, respectively, at 12 weeks (P = .006); and 2.6 and 7.4, respectively, at 24 weeks (P = .012).

CONCLUSIONS

The ICRS macroscopic scores and modified Wakitani scores showed that a single-stage surgical procedure combining microfracture and a PRF membrane was more effective than surgery with only microfracture for promoting cartilage repair.

CLINICAL RELEVANCE

A single-stage surgical procedure combining microfracture and an autologous PRF membrane is a potentially beneficial treatment method for cartilage defects that does not require using any xenocollagen membrane.

摘要

目的

在兔模型中,确定将微骨折术与自体富含血小板纤维蛋白(PRF)膜相结合的单阶段手术在软骨修复中的体内有效性。

方法

在成年白兔的滑车沟中创建软骨缺损。将缺损分为 2 种治疗组:仅微骨折(对照组)和 PRF 膜覆盖的微骨折(PRF 组)。为了评估修复的软骨,在术后 4、12 和 24 周使用国际软骨修复协会(ICRS)宏观评分系统和改良 Wakitani 组织学分级系统进行评估。

结果

在对照组和 PRF 组中,平均 ICRS 宏观评分分别为 4 周时的 4.1 和 5.8(P =.0623);12 周时的 6.3 和 9.8(P =.006);24 周时的 6.5 和 10.3(P =.010)。在对照组和 PRF 组中,平均改良 Wakitani 评分分别为 4 周时的 4.0 和 3.9(P >.999);12 周时的 5.3 和 10.4(P =.006);24 周时的 2.6 和 7.4(P =.012)。

结论

ICRS 宏观评分和改良 Wakitani 评分表明,与仅微骨折手术相比,微骨折术与 PRF 膜联合的单阶段手术更能有效促进软骨修复。

临床相关性

将微骨折术与自体 PRF 膜相结合的单阶段手术是一种潜在有益的治疗方法,可用于治疗软骨缺损,无需使用任何异种胶原膜。

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