Autologous bone marrow stromal cell transplantation for repair of full-thickness articular cartilage defects in human patellae: Two case reports
Autologous bone marrow stromal cell transplantation for repair of full-thickness articular cartilage defects in human patellae: Two case reports
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DOI：
10.3727/000000004783983747
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发表时间：
2004-01-01
影响因子：
3.3
通讯作者：
Horibe, Shuji
中科院分区：
文献类型：
--
作者：
Wakitani, Shigeyuki;Mitsuoka, Tomoki;Horibe, Shuji
本研究评估了自体骨髓基质细胞移植修复一名26岁女性和一名44岁男性的全层关节软骨缺损的效果。这两名患者因膝部疼痛导致无法正常行走而到我们诊所就诊。经过彻底的检查，我们得出结论，膝关节疼痛是由于关节软骨的损伤，并决定采用骨髓基质细胞移植修复缺损。在移植前三周，从每个患者的髂骨中抽取骨髓。在使用葡聚糖去除红细胞后，将剩余的有核细胞放入培养中。当附着的细胞达到亚融合时，它们被传代以在培养中扩张。随后收集贴壁细胞，将其包埋在胶原胶中，移植到膝盖骨的关节软骨缺损处，并覆盖自体骨膜。移植后6个月，临床症状(疼痛、行走能力)明显改善，且持续有效(1例移植后5年9个月，1例移植后4年)，两例患者对结果均满意。早在移植后2个月，缺损处就被组织覆盖，呈轻度异色染色。第二次移植后第一年和第一年分别行关节镜检查和纤维软骨修复。结果表明，自体骨髓基质细胞移植是促进关节软骨缺损修复的有效方法。
This study assessed the effectiveness of autologous bone marrow stromal cell transplantation for the repair of full-thickness articular cartilage defects in the patellae of a 26-year-old female and a 44-year-old male. These two patients presented in our clinic because their knee pain prevented them from walking normally. After thorough examination, we concluded that the knee pain was due to the injured articular cartilage and decided to repair the defect with bone marrow stromal cell transplantation. Three weeks before transplantation, bone marrow was aspirated from the iliac crest of each patient. After erythrocytes had been removed by use of dextran, the remaining nucleated cells were placed in culture. When the attached cells reached subconfluence, they were passaged to expand in culture. Adherent cells were subsequently collected, embedded in a collagen gel, transplanted into the articular cartilage defect in the patellae, and covered with autologous periosteum. Six months after transplantation, clinical symptoms (pain and walking ability) had improved significantly and the improvement has remained in effect (5 years and 9 months posttransplantation in one case, and 4 years in the other), and both patients have been satisfied with the outcome. As early as 2 months after transplantation, the defects were covered with tissue that showed slight metachromatic staining. Two years after the first and I year after the second transplantation, arthroscopy was performed and the defects were repaired with fibrocartilage. Results indicate autologous bone marrow stromal cell transplantation is an effective approach in promoting the repair of articular cartilage defects.