Binder Harald, Hoffman Lukas, Zak Lukas, Tiefenboeck Thomas, Aldrian Silke, Albrecht Christian
Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
First Orthopedic Department, Orthopedic Hospital Vienna Speising, Vienna, Austria.
Bone Joint Res. 2021 Jul;10(7):370-379. doi: 10.1302/2046-3758.107.BJR-2020-0370.R1.
The aim of this retrospective study was to determine if there are differences in short-term clinical outcomes among four different types of matrix-associated autologous chondrocyte transplantation (MACT).
A total of 88 patients (mean age 34 years (SD 10.03), mean BMI 25 kg/m (SD 3.51)) with full-thickness chondral lesions of the tibiofemoral joint who underwent MACT were included in this study. Clinical examinations were performed preoperatively and 24 months after transplantation. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) Subjective Knee Form, the Brittberg score, the Tegner Activity Scale, and the visual analogue scale (VAS) for pain. The Kruskal-Wallis test by ranks was used to compare the clinical scores of the different transplant types.
The mean defect size of the tibiofemoral joint compartment was 4.28 cm (SD 1.70). In total, 11 patients (12.6%) underwent transplantation with Chondro-Gide (matrix-associated autologous chondrocyte implantation (MACI)), 40 patients (46.0%) with Hyalograft C (HYAFF), 21 patients (24.1%) with Cartilage Regeneration System (CaReS), and 15 patients (17.2%) with NOVOCART 3D. The mean IKDC Subjective Knee Form score improved from 35.71 (SD 6.44) preoperatively to 75.26 (SD 18.36) after 24 months postoperatively in the Hyalograft group, from 35.94 (SD 10.29) to 71.57 (SD 16.31) in the Chondro-Gide (MACI) group, from 37.06 (SD 5.42) to 71.49 (SD 6.76) in the NOVOCART 3D group, and from 45.05 (SD 15.83) to 70.33 (SD 19.65) in the CaReS group. Similar improvements were observed in the VAS and Brittberg scores.
Two years postoperatively, there were no significant differences in terms of outcomes. Our data demonstrated that MACT, regardless of the implants used, resulted in good clinical improvement two years after transplantation for localized tibiofemoral defects. Cite this article: 2021;10(7):370-379.
本回顾性研究旨在确定四种不同类型的基质相关自体软骨细胞移植（MACT）在短期临床疗效上是否存在差异。
本研究纳入了88例接受MACT治疗的胫股关节全层软骨损伤患者（平均年龄34岁（标准差10.03），平均体重指数25kg/m²（标准差3.51））。在术前和移植后24个月进行临床检查。使用国际膝关节文献委员会（IKDC）主观膝关节评分表、布里特伯格评分、特格纳活动量表和疼痛视觉模拟量表（VAS）评估临床疗效。采用秩和检验的Kruskal-Wallis检验比较不同移植类型的临床评分。
胫股关节腔的平均缺损大小为4.28cm²（标准差1.70）。共有11例患者（12.6%）接受了Chondro-Gide（基质相关自体软骨细胞植入术（MACI））移植，40例患者（46.0%）接受了Hyalograft C（HYAFF）移植，21例患者（24.1%）接受了软骨再生系统（CaReS）移植，15例患者（17.2%）接受了NOVOCART 3D移植。Hyalograft组术后24个月时，IKDC主观膝关节评分表的平均得分从术前的35.71（标准差6.44）提高到75.26（标准差18.36），Chondro-Gide（MACI）组从35.94（标准差10.29）提高到71.57（标准差16.31），NOVOCART 3D组从37.06（标准差5.42）提高到71.49（标准差6.76），CaReS组从45.05（标准差15.83）提高到70.33（标准差19.65）。VAS评分和布里特伯格评分也有类似改善。
术后两年，疗效方面无显著差异。我们的数据表明，对于局限性胫股关节缺损，无论使用何种植入物，MACT在移植两年后均能带来良好的临床改善。引用本文：2021;10(7):370 - 379。
