Lyu Jialing, Geng Hongli, Zhu Weimin, Li Dingfu, Chen Kang, Ye Hui, Xia Jun
Department of Radiology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Sungang Road West, Futian District, Shenzhen, Guangdong Province, China.
Department of Rehabilitation Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Int Orthop. 2023 Oct;47(10):2383-2390. doi: 10.1007/s00264-022-05581-0. Epub 2022 Oct 5.
To investigate whether the quality of cartilage repair tissue is associated with patellofemoral osteoarthritis (PFOA) at a three year follow-up after matrix-induced autologous chondrocyte implantation (MACI).
This retrospective study included 32 patients who underwent MACI between October 2014 and May 2018 at our institute. The Lysholm score and Visual Analog Scale (VAS) score were assessed. The magnetic resonance observation of cartilage repair tissue (MOCART) 2.0 score and T2* relaxation time of repair tissue were used to evaluate cartilage repair tissue quality. A modified MRI Osteoarthritis Knee Score (mMOAKS) was used to evaluate PFOA.
Compared with pre-operative scores, the final Lysholm score (50.71 ± 2.22 vs 89.70 ± 1.18; t = 15.5, P < 0.0001) and VAS score (4.67 ± 0.47 vs 0.92 ± 0.64; t = 22.62, P < 0.0001) were improved at 3 years after MACI. At the three year follow-up, the mean MOCART 2.0 score was 61.56 ± 18.11, and the T2* relaxation time of the repair tissue was significantly lower than that in the healthy control region (24.11 ± 6.38 vs 34.39 ± 1.33, t = - 8.635, P < 0.0001). The mean mMOAKS score was 9.16 ± 4.51. On univariate analysis, the MOCART 2.0 score and T2* relaxation time were negatively associated with the mMOAKS score.
MACI can lead to significant pain relief and restoration of knee joint function, and good quality cartilage repair tissue was a protective factor against PFOA at the three year follow-up.
在基质诱导自体软骨细胞植入(MACI)术后三年随访时,研究软骨修复组织的质量是否与髌股关节炎(PFOA)相关。
这项回顾性研究纳入了2014年10月至2018年5月在我院接受MACI手术的32例患者。评估Lysholm评分和视觉模拟量表(VAS)评分。采用软骨修复组织磁共振观察(MOCART)2.0评分及修复组织的T2*弛豫时间来评估软骨修复组织质量。使用改良的膝关节磁共振骨关节炎评分(mMOAKS)来评估PFOA。
与术前评分相比,MACI术后三年时最终的Lysholm评分(50.71±2.22对89.70±1.18;t = 15.5,P < 0.0001)和VAS评分(4.67±0.47对0.92±0.64;t = 22.62,P < 0.0001)得到改善。在三年随访时,MOCART 2.0评分的平均值为61.56±18.11,修复组织的T2弛豫时间显著低于健康对照区域(24.11±6.38对34.39±1.33,t = -8.635,P < 0.0001)。mMOAKS评分的平均值为9.16±4.51。单因素分析显示,MOCART 2.0评分和T2弛豫时间与mMOAKS评分呈负相关。
MACI可显著缓解疼痛并恢复膝关节功能,在三年随访时,高质量的软骨修复组织是预防PFOA的保护因素。