Alvarez-Lozano Eduardo, Martinez-Rodriguez Herminia, Forriol Francisco
Departamento de Cirurgia Ortopédica, Hospital Jose E Gonzalez, Universidad Autonóma de Nuevo Leon, Monterrey, México.
Departamento de Bioquímica, Universidad Autonóma de Nuevo Leon, Monterrey, México.
Rev Bras Ortop (Sao Paulo). 2021 Aug;56(4):470-477. doi: 10.1055/s-0040-1716764. Epub 2020 Oct 29.
The aim of our study is to analyze the clinical and functional results obtained using autologous chondrocytes embedded in a fibrin scaffold in knee joint injuries. We included 56 patients, 36 men and 20 women, with a mean age 36 years. Six of the patients were professional athletes, with single knee injuries that were either chondral or osteochondral (43 chondral, 9 osteochondral, 2 cases of osteochondritis dissecans and 2 osteochondral fractures), 2 to 10 cm in size and ≤ 10 mm deep, with no signs of osteoarthritis. The location of the injury was in the patella (8), the medial femoral condyle (40) and lateral femoral condyle (7) and one in the trochlea. The mean follow-up was 3 (range: 1-6) years. The clinical course was assessed using the Cincinnati and Knee Injury and Osteoarthritis Outcome (KOOS) scores, 6 and 12 months after surgery. The paired Student t-test was used to compare pre-and postoperative results. Six months after the implant, patients resumed their everyday activities. On the assessment scores, their condition was improving in comparison with their presurgical state ( < 0.05). They were also able to carry out their sporting activities more easily than prior to surgery ( < 0.05). The seeding of chondrocytes in fibrin may provide a favorable micro-environment for the synthesis of extracellular matrix and improved the clinical condition and activity of the patients 1 year after surgery.
我们研究的目的是分析在膝关节损伤中使用嵌入纤维蛋白支架的自体软骨细胞所获得的临床和功能结果。我们纳入了56例患者，其中男性36例，女性20例，平均年龄36岁。6例患者为职业运动员，均为单膝关节损伤，损伤类型为软骨损伤或骨软骨损伤（软骨损伤43例，骨软骨损伤9例，剥脱性骨软骨炎2例，骨软骨骨折2例），损伤大小为2至10厘米，深度≤10毫米，无骨关节炎迹象。损伤部位位于髌骨（8例）、股骨内侧髁（40例）、股骨外侧髁（7例）和滑车1例。平均随访时间为3年（范围：1至6年）。在术后6个月和12个月，使用辛辛那提评分和膝关节损伤与骨关节炎疗效评分（KOOS）评估临床病程。采用配对学生t检验比较术前和术后结果。植入6个月后，患者恢复了日常活动。在评估评分方面，与术前状态相比，他们的状况有所改善（P<0.05）。与手术前相比，他们也能够更轻松地进行体育活动（P<0.05）。纤维蛋白中软骨细胞的接种可能为细胞外基质的合成提供了有利的微环境，并改善了患者术后1年的临床状况和活动能力。
