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自体基质诱导软骨生成联合外周血浓缩物(AMIC+PBC)用于踝关节软骨损伤,作为复杂手术方法的一部分——5年随访

Autologous matrix induced chondrogenesis plus peripheral blood concentrate (AMIC+PBC) in chondral lesions at the ankle as part of a complex surgical approach - 5-year follow-up.

作者信息

Richter Martinus, Zech Stefan, Meissner Stefan, Naef Issam

机构信息

Department for Foot and Ankle Surgery Rummelsberg and Nuremberg, Germany.

Department for Foot and Ankle Surgery Rummelsberg and Nuremberg, Germany.

出版信息

Foot Ankle Surg. 2022 Dec;28(8):1321-1326. doi: 10.1016/j.fas.2022.06.015. Epub 2022 Jul 3.

DOI:10.1016/j.fas.2022.06.015
PMID:35803836
Abstract

BACKGROUND

The aim of the study was to assess 5-year-follow-up (5FU) after Autologous Matrix Induced Chondrogenesis plus Peripheral Blood Concentrate (AMIC+PBC) in chondral lesions at the ankle as part of a complex surgical approach.

METHODS

In a prospective consecutive non-controlled clinical follow-up study, all patients with chondral lesion at the ankle treated with AMIC+PBC from July 17, 2016 to May 31, 2017 were included. Size and location of the chondral lesions, the Visual-Analogue-Scale Foot and Ankle (VAS FA) and the EFAS Score before treatment and at 5FU were analysed and compared with previous 2-year-follow-up (2FU). Peripheral Blood Concentrate (PBC) was used to impregnate a collagen I/III matrix (Chondro-Gide, Wolhusen, Switzerland) that was fixed into the chondral lesion with fibrin glue.

RESULTS

One hundred and twenty-nine patients with 136 chondral lesions were included in the study. The chondral lesions were located as follows (n (%)), medial talar shoulder only, 62 (46); lateral talar shoulder only, 42 (31); medial and lateral talar shoulder, 7 (10); tibia, 18 (13). The average for lesion size was 1.8 cm, for VAS FA 45.7 and for EFAS Score 9.8. 2FU/5FU was completed in 105 (81 %)/104(81 %) patients with 112/111 previous chondral lesions. VAS FA improved to 79.8/84.2 and EFAS Score to 20.3/21.5 (2FU/5FU). No parameter significantly differed 2FU and 5FU.

CONCLUSIONS

AMIC+PBC as part of a complex surgical approach led to improved and high validated outcome scores at 2FU/5FU. 2FU and 5FU did not differ.

摘要

背景

本研究的目的是评估自体基质诱导软骨形成联合外周血浓缩物(AMIC+PBC)治疗踝关节软骨损伤5年随访(5FU)的效果,这是一种复杂手术方法的一部分。

方法

在一项前瞻性连续非对照临床随访研究中,纳入了2016年7月17日至2017年5月31日期间接受AMIC+PBC治疗的所有踝关节软骨损伤患者。分析并比较治疗前和5FU时软骨损伤的大小和位置、视觉模拟量表足踝(VAS FA)和EFAS评分,并与之前的2年随访(2FU)进行比较。外周血浓缩物(PBC)用于浸渍I/III型胶原基质(Chondro-Gide,瑞士沃尔胡森),并用纤维蛋白胶固定在软骨损伤处。

结果

129例患者共136处软骨损伤纳入研究。软骨损伤的位置分布如下(n(%)),仅内侧距骨肩,62处(46%);仅外侧距骨肩,42处(31%);内侧和外侧距骨肩,7处(10%);胫骨,18处(13%)。损伤大小的平均值为1.8cm,VAS FA为45.7,EFAS评分为9.8。105例(81%)/104例(81%)有112处/111处既往软骨损伤的患者完成了2FU/5FU。VAS FA改善至79.8/84.2,EFAS评分改善至20.3/21.5(2FU/5FU)。2FU和5FU时各参数无显著差异。

结论

AMIC+PBC作为一种复杂手术方法的一部分,在2FU/5FU时可提高并获得高度验证的结果评分。2FU和5FU无差异。

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引用本文的文献

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EFORT Open Rev. 2024 Mar 5;9(3):217-234. doi: 10.1530/EOR-23-0075.
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Positive outcomes following Autologous Matrix-Induced Chondrogenesis (AMIC) in the treatment of retropatellar chondral lesions: a retrospective analysis of a patient registry.自体诱导多能干细胞软骨生成术(AMIC)治疗髌前软骨病变的疗效:患者注册登记的回顾性分析。
BMC Musculoskelet Disord. 2023 Dec 11;24(1):964. doi: 10.1186/s12891-023-06923-8.
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The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions.
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Cartilage. 2023 Jun;14(2):180-197. doi: 10.1177/19476035231154746. Epub 2023 Mar 9.