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用于碎软骨修复的滑膜密封剂变体:技术说明与回顾性研究。

The Synovial Sealant Variant for Minced Cartilage Repair: A Technical Note and Retrospective Study.

作者信息

Ahrens Philipp, Hinterwimmer Stefan, Tasser Matthias, Fritsch Lorenz, Siebenlist Sebastian, Fürmetz Julian, Watrinet Julius

机构信息

Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany.

OrthoPlus, Lenbachplatz 2a, 80333 Munich, Germany.

出版信息

Indian J Orthop. 2024 May 24;58(8):1027-1034. doi: 10.1007/s43465-024-01174-8. eCollection 2024 Aug.

Abstract

PURPOSE

Cartilage defects are a common pathology in active people and affect quality of life. A common treatment option is treatment with minced cartilage (MC). As conservative therapy has a limited effect, surgical treatments vary in terms of procedure and results. A modified technique for autologous cartilage repair is presented here.

METHOD

MC was modified by adding a synovial sealant. This improves the stability of the graft, allowing the cartilage to proliferate. The synovial tissue has the potential to stimulate the implanted cartilage, which promotes healing and regeneration. The clinical and functional results of the modified technique were examined in a retrospective case series.

RESULTS

The technique has proven to be reproducible for retropatellar cartilage defects and is both efficient and cost effective. MC with synovial sealing was performed in ten patients with retropatellar cartilage damage. In the conducted cases serious, 10 patients were available for follow-up after 18 ± 3 months. Patients showed good clinical results in terms of pain (VAS = 1.9, KOOS Pain = 89.7), symptoms (KOOS Symptoms = 83.6), and daily activity (KOOS Activity = 96.6).

CONCLUSION

The procedure combines the advantages of autologous cartilage repair with a one-stage surgical approach. It utilizes the regenerative potential of synovial tissue while providing improved mechanical stability. This technique offers a cost-effective, autologous solution for full-thickness cartilage defects, and shows promising clinical results in the medium term.

摘要

目的

软骨缺损在活跃人群中是一种常见的病理状况,会影响生活质量。一种常见的治疗选择是使用碎软骨(MC)进行治疗。由于保守治疗效果有限,手术治疗在操作和结果方面存在差异。本文介绍一种改良的自体软骨修复技术。

方法

通过添加滑膜密封剂对MC进行改良。这提高了移植物的稳定性,使软骨能够增殖。滑膜组织具有刺激植入软骨的潜力,从而促进愈合和再生。在一项回顾性病例系列研究中对改良技术的临床和功能结果进行了检查。

结果

该技术已被证明可重复用于髌后软骨缺损,且高效且具有成本效益。对10例髌后软骨损伤患者进行了带滑膜密封的MC治疗。在纳入的病例中,10例患者在18±3个月后可进行随访。患者在疼痛(视觉模拟评分法[VAS]=1.9,膝关节损伤和骨关节炎疗效评分系统[KOOS]疼痛评分=89.7)、症状(KOOS症状评分=83.6)和日常活动(KOOS活动评分=96.6)方面均显示出良好的临床效果。

结论

该手术结合了自体软骨修复的优点和一期手术方法。它利用了滑膜组织的再生潜力,同时提供了更好的机械稳定性。这项技术为全层软骨缺损提供了一种具有成本效益的自体解决方案,并在中期显示出有前景的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a79/11286892/118631d1c95a/43465_2024_1174_Fig1_HTML.jpg

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