Villa Maria Hospital, Viale Matteotti, 4 - 47921, Rimini, Italy.
Orthopaedic and Traumatology Clinic, Ospedale "SS. Annunziata" - Università degli Studi Gabriele d'Annunzio - Chieti e Pescara, Via dei Vestini, 31 - 66100, Chieti, Italy.
Eur J Orthop Surg Traumatol. 2023 May;33(4):857-867. doi: 10.1007/s00590-022-03214-1. Epub 2022 Feb 8.
Osteochondritis dissecans (OCD) is a common cartilage disorder that specifically affects the knees of skeletally immature and young adult patients. There have been a few treatments that have been proposed: fixation of the fragment, drilling, microfractures. The aim of this study was to analyze retrospectively clinical and imaging results obtained by treating it with one-step bone marrow-derived cells Transplantation (BMDCT) technique.
From 2007 to 2014, 18 patients (mean-age 19.1 ± 5.0 years) affected by OCD were treated with one-step BMDC transplantation. In our observational study, clinical evaluation was performed at a scheduled follow-up through IKDC, Tegner, KOOS and EQ-VAS. X-rays and MRI were conducted preoperatively and at 12 months. At final follow-up, MRI MOCART Score was evaluated.
IKDC and KOOS clinical scores showed a progressive increase. Tegner Score at final follow-up (5.3 ± 2.7) was significantly lower compared to the pre-injury level (6.5 ± 2.1); however, these results showed a statistically significant improvement that remained over time. EQ-VAS showed a significant improvement in every follow-up measure. MRI Mocart Score showed a complete or almost complete filling of the lesion in 13 patients.
"One-step" technique allows articular surface restoration with viable physiologic osteochondral tissue with a high clinical efficacy and imaging results. The number of cases is still limited, and further studies with larger sample sizes and greater follow-up evaluations are required to confirm our results. Nevertheless, we believe that BMDCT may represent a suitable option to treat OCD lesion in young adults.
剥脱性骨软骨炎（OCD）是一种常见的软骨疾病，主要影响未成熟和年轻成年患者的膝关节。目前已经提出了几种治疗方法：碎片固定、钻孔、微骨折。本研究旨在回顾性分析采用骨髓源性细胞移植（BMDCT）技术治疗的临床和影像学结果。
2007 年至 2014 年，18 例（平均年龄 19.1±5.0 岁）OCD 患者采用一步法 BMDC 移植治疗。在我们的观察性研究中，通过 IKDC、Tegner、KOOS 和 EQ-VAS 在预定随访时进行临床评估。术前和 12 个月进行 X 线和 MRI 检查。在最终随访时，评估 MRI MOCART 评分。
IKDC 和 KOOS 临床评分呈逐渐增加趋势。最终随访时 Tegner 评分（5.3±2.7）明显低于损伤前水平（6.5±2.1）；然而，这些结果显示出随着时间的推移而持续改善，具有统计学意义。EQ-VAS 在每次随访中均显示出显著改善。MRI Mocart 评分显示 13 例患者的病变完全或几乎完全填充。
“一步”技术可通过具有生理活性的骨软骨组织恢复关节表面，具有较高的临床疗效和影像学结果。病例数量仍然有限，需要进一步的研究，包括更大的样本量和更长的随访评估，以证实我们的结果。然而，我们认为 BMDCT 可能是治疗年轻成年人 OCD 病变的一种合适选择。
