Treatment of a full-thickness articular cartilage defect in the femoral condyle of an athlete with autologous bone-marrow stromal cells
Treatment of a full-thickness articular cartilage defect in the femoral condyle of an athlete with autologous bone-marrow stromal cells
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DOI：
10.1016/j.joca.2006.08.008
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发表时间：
2007-02-01
影响因子：
7
通讯作者：
Kurosaka, M.
中科院分区：
文献类型：
--
作者：
Kuroda, R.;Ishida, K.;Kurosaka, M.
目的：人类骨髓基质细胞被认为是多能的，即使在成人中也是如此。这项研究评估了自体骨髓基质细胞植入胶原支架修复运动员股骨内侧髁全层关节软骨缺损的效果。患者和方法：回顾31岁男性柔道运动员右膝疼痛。在股骨内侧的负重区发现一个20×30 mm的全层软骨缺损(国际软骨修复协会分类(ICRS)IV级)。在患者知情同意的情况下，用自体骨髓基质细胞修复了缺损处。手术前4周从患者的髂骨中抽取骨髓。去除红细胞后，剩余的细胞在培养中扩增。收集贴壁细胞，将其包埋于胶原胶中，将胶原胶转移至股骨内侧髁关节软骨缺损处。结果：术后7个月，关节镜下可见缺损处被光滑的组织覆盖。组织学上，缺损处被透明样软骨组织填充，番红花素-O染色阳性。术后一年，临床症状明显改善。结论：自体骨髓基质细胞移植可促进年轻活动期患者关节软骨大面积局灶性缺损的修复。(C)2006年国际骨性关节炎研究会。爱思唯尔有限公司出版。保留所有权利。
Objectives: Human bone-marrow stromal cells are believed to be multipotent even in adults. This study assessed the effectiveness of autologous bone-marrow stromal cells, which were embedded within a collagen scaffold, to repair a full-thickness articular cartilage defect in the medial femoral condyle of an athlete.Patient and methods: A 31-year-old male judo player suffering from pain in the right knee was reviewed. A 20 x 30-mm full-thickness cartilage defect (International Cartilage Repair Society classification (ICRS) grade IV) was revealed in the weight-bearing area of the medial femoral condyle. With the informed consent of the patient, the defect was treated with autologous bone-marrow stromal cells. Bone marrow was aspirated from the iliac crest of the patient 4 weeks before surgery. After removing the erythrocytes, the remaining cells were expanded in culture. Adherent cells were collected and embedded within a collagen gel, which was transferred to the articular cartilage defect in the medial femoral condyle. The implant was covered with an autologous periosteal flap.Results: Seven months after surgery, arthroscopy revealed the defect to be covered with smooth tissues. Histologically, the defect was filled with a hyaline-like type of cartilage tissue which stained positively with Safranin-O. One year after surgery, the clinical symptoms had improved significantly. The patient had reattained his previous activity level and experienced neither pain nor other complications.Conclusions: Our findings indicate that the transplantation of autologous bone-marrow stromal cells can promote the repair of large focal articular cartilage defects in young, active patients. (C) 2006 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.