Ochsner Medical Center, Department of Orthopaedic Surgery, New Orleans, Louisiana, USA.
Ochsner Sports Medicine Institute, University of Queensland, Ochsner Clinical School, New Orleans, Louisiana, USA.
Knee Surg Sports Traumatol Arthrosc. 2024 Mar;32(3):636-644. doi: 10.1002/ksa.12074. Epub 2024 Feb 23.
Viable cartilage allograft (VCA) is a cartilage tissue matrix that contains cryopreserved viable allogeneic cartilage fibres. This study aimed to assess safety and benefits in treating focal knee cartilage defects with VCA. We hypothesized that VCA is a safe single-stage procedure in isolated chondral defects.
In vitro analysis, in vivo studies and a prospective case series were performed. VCA was evaluated in a goat cartilage repair model. Symptomatic International Cartilage Repair Society grade 3/4A lesions of the femoral condyle or patella were implanted with VCA. International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome (KOOS) subscales, Lysholm, Short Form-12, Visual Analog Scale and pain frequency levels were assessed. Radiographic and magnetic resonance imaging (MRI) was performed at regular intervals postoperatively. Data were analysed by statisticians to determine the power and significance of the results.
The goat study confirmed that VCA is effective for cartilage repair. Twenty patients were implanted; the mean age was 28.1 (16-56), the mean body mass index (BMI) was 27.9 ± 5.6 and the mean follow-up was 24.1 months (range = 12.0-36.0 months). Lesions were in either the femoral condyle (7) or patella (13). Lesion sizes ranged from 1.5 to 6.0 cm (mean = 4.58 cm ). Outcome scores improved from preoperative baseline (POB): IKDC (78.2), Lysholm (89.0), KOOS: Pain (95.8), Symptoms (86.3), ADL (87.8), Sports (85.0) and QOL (75.0). MRI imaging demonstrated excellent osteochondral allograft assimilation. Second-look arthroscopy (two patients) demonstrated complete fill and incorporation (Brittberg scores 11/12). Functional scores were maintained at 24 (M): IKDC (86.24 ± 17.2), Lysholm (87.23 ± 15.0), KOOS: Pain (91.72 ± 17.3), Symptoms (84.92 ± 16.1), ADLs (93.80 ± 16.1), Sports (84.45 ± 27.7), QOL (81.30 ± 20.8).
VCA is an off-the-shelf, single-stage, conformable allogeneic graft that treats chondral defects with no additional fixation. Preclinical and short-term prospective clinical studies show that VCA can safely treat chondral defects with potential advantages to existing options.
Level IV study.
活性软骨同种异体移植物（VCA）是一种含有冷冻保存的活性同种异体软骨纤维的软骨组织基质。本研究旨在评估 VCA 治疗膝关节局灶性软骨缺损的安全性和益处。我们假设 VCA 是一种安全的单一阶段手术，适用于孤立的软骨缺损。
进行了体外分析、体内研究和前瞻性病例系列研究。在山羊软骨修复模型中评估了 VCA。将股骨髁或髌骨的有症状的国际软骨修复学会（ICRS）3/4A 级病变植入 VCA。评估国际膝关节文献委员会（IKDC）、膝关节损伤和骨关节炎结果（KOOS）量表、Lysholm、简短表单-12、视觉模拟量表和疼痛频率水平。术后定期进行影像学和磁共振成像（MRI）检查。数据由统计学家进行分析，以确定结果的效力和显著性。
山羊研究证实 VCA 可有效修复软骨。共植入 20 例患者；平均年龄为 28.1（16-56）岁，平均体重指数（BMI）为 27.9±5.6，平均随访时间为 24.1 个月（范围 12.0-36.0 个月）。病变位于股骨髁（7 例）或髌骨（13 例）。病变大小从 1.5 到 6.0cm（平均 4.58cm）。术前基线（POB）的结果评分提高：IKDC（78.2）、Lysholm（89.0）、KOOS：疼痛（95.8）、症状（86.3）、ADL（87.8）、运动（85.0）和生活质量（75.0）。MRI 成像显示出出色的骨软骨同种异体移植物同化。二次关节镜检查（两名患者）显示完全填充和整合（Brittberg 评分 11/12）。24 个月时（M）的功能评分保持不变：IKDC（86.24±17.2）、Lysholm（87.23±15.0）、KOOS：疼痛（91.72±17.3）、症状（84.92±16.1）、ADL（93.80±16.1）、运动（84.45±27.7）、生活质量（81.30±20.8）。
VCA 是一种即用型、单一阶段、顺应性同种异体移植物，可治疗无额外固定的软骨缺损。临床前和短期前瞻性临床研究表明，VCA 可以安全地治疗软骨缺损，并且具有优于现有选择的潜在优势。
IV 级研究。
