Division of Medical Education, School of Medical Sciences, The University of Manchester, Manchester, UK.
Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK.
Knee. 2023 Oct;44:31-42. doi: 10.1016/j.knee.2023.07.004. Epub 2023 Jul 27.
Autologous chondrocyte implantation (ACI) is primarily performed in active, young patients to treat knee pain and functional limitations resulting from articular cartilage injury. Nevertheless, the functional outcomes of ACI remain poorly understood. This systematic review aimed to evaluate the biomechanical and functional outcomes of ACI.
Ovid MEDLINE, Embase, and Web of Science were systematically searched using the terms 'Knee OR Knee joint AND Autologous chondrocyte implantation OR ACI'. Inclusion and exclusion criteria were used to screen publications by title, abstract, and full text. Study quality and bias were assessed by two reviewers. Means and standard deviations of all collected variables were calculated and presented in the review.
CRD42021238768.
Nineteen articles including 20 ACI cohorts were included. In general, the average range of motion (ROM) improved with clinical (>5°) and statistical significance (p < 0.05) postoperatively: 130.5 ± 14.8° to 136.1 ± 10.2°. Knee strength significantly improved within the first two postoperative years but remained poorer than control groups at final follow-up. No statistical differences were found between ACI and control groups in their ability to perform functional activities like the 6-minute walk test.
Knee range of motion generally improved following ACI. Although, some studies reported that knee strengths remained significantly poorer than healthy controls, particularly >2-years postoperatively, implying that longer-term strength training may benefit patients.However, the volume of research and current level of evidence remain low, thus further research is required to better understand the impact of ACI on knee function and guide future rehabilitative protocols.
自体软骨细胞移植（ACI）主要用于治疗因关节软骨损伤导致膝关节疼痛和功能受限的活跃年轻患者。然而，ACI 的功能结果仍知之甚少。本系统评价旨在评估 ACI 的生物力学和功能结果。
通过标题、摘要和全文筛选文献，使用“膝关节或膝关节和自体软骨细胞移植或 ACI”等术语对 Ovid MEDLINE、Embase 和 Web of Science 进行系统检索。使用纳入和排除标准筛选出版物。两位审稿人评估研究质量和偏倚。计算所有收集变量的平均值和标准差，并在综述中呈现。
CRD42021238768。
纳入了 19 篇文章，共包含 20 个 ACI 队列。总体而言，术后临床（>5°）和统计学意义（p<0.05）上平均活动度（ROM）改善：130.5±14.8°至 136.1±10.2°。膝关节力量在前两年内显著改善，但在最终随访时仍比对照组差。在进行 6 分钟步行测试等功能性活动的能力方面，ACI 组与对照组之间未发现统计学差异。
ACI 后膝关节活动度通常会改善。尽管一些研究报告称，膝关节力量仍明显比健康对照组差，尤其是术后>2 年，这表明长期的力量训练可能对患者有益。然而，研究的数量和当前的证据水平仍然较低，因此需要进一步的研究来更好地了解 ACI 对膝关节功能的影响，并指导未来的康复方案。
