Rayes Johnny, Sparavalo Sara, Wong Ivan
Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, 5955 Veteran's Memorial Lane, Room 2106 VMB, Halifax, Nova Scotia, B3H 2E1, Canada.
Curr Rev Musculoskelet Med. 2021 Dec;14(6):328-339. doi: 10.1007/s12178-021-09721-8. Epub 2021 Nov 15.
A wide array of joint-preserving surgical techniques exists in the management of acetabular chondral defects (ACDs). The purpose of this review is to summarize the clinical outcomes of the recent biologics used to treat ACDs during hip arthroscopy.
Increasing evidence is available for different biological solutions used in the hip. Studies have shown promising outcomes with minimal complications when using biologics as augmentation to microfracture (MF), including different scaffolds or stem cells, or to enhance autologous chondrocyte implantation (ACI). However, data so far is scarce, and more trials and longer follow-ups are needed to better delineate the appropriate indications and benefits for each technique. Presently, the level of evidence is low, but in general, biologics appear safe and trend toward beneficial compared to standard surgical techniques. Augmented MF is recommended for small to medium ACDs, and matrix-assisted ACI or three-dimensional ACI is recommended for medium to large defects.
在髋臼软骨损伤（ACD）的治疗中存在多种保关节手术技术。本综述的目的是总结近期在髋关节镜检查期间用于治疗ACD的生物制剂的临床结果。
越来越多的证据表明髋关节使用了不同的生物解决方案。研究表明，当将生物制剂作为微骨折（MF）的增强手段时，包括使用不同的支架或干细胞，或用于增强自体软骨细胞植入（ACI），可取得有前景的结果且并发症极少。然而，目前数据稀缺，需要更多试验和更长时间的随访来更好地界定每种技术的合适适应症和益处。目前，证据水平较低，但总体而言，与标准手术技术相比，生物制剂似乎是安全的且有有益趋势。对于中小型ACD，推荐使用增强型MF；对于中大型缺损，推荐使用基质辅助ACI或三维ACI。
