Evaluating Joint Morbidity after Chondral Harvest for Autologous Chondrocyte Implantation (ACI): A Study of ACI-Treated Ankles and Hips with a Knee Chondral Harvest.
Evaluating Joint Morbidity after Chondral Harvest for Autologous Chondrocyte Implantation (ACI): A Study of ACI-Treated Ankles and Hips with a Knee Chondral Harvest.
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DOI：
10.1177/1947603515607963
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发表时间：
2016-01
期刊：
影响因子：
2.8
通讯作者：
Roberts S
中科院分区：
文献类型：
--
作者：
McCarthy HS;Richardson JB;Parker JC;Roberts S
为了确定获取软骨作为自体软骨细胞植入（ACI）的软骨细胞来源是否会导致供体部位的发病率。23例患者因踝关节或髋关节软骨缺损行ACI。这包括膝关节软骨摘取（I期）、实验室软骨细胞扩增和植入手术（II期）。在软骨摘取术之前，没有患者为其膝关节寻求治疗。Lysholm膝关节评分在软骨摘除术前和每年一次aci后完成。另外3例既往有膝关节ACI的患者在12.3±1.5个月时对供体部位进行组织学分析。术前Lysholm评分中位数为100，在术后13.7±1.7个月和4.8±1.8年均无显著差异（Lysholm评分中位数分别为91.7和87.5）。与从髁间切迹取软骨的患者（Lysholm中位评分66.7）相比，从中央或内侧滑车取软骨的患者在最近的随访中Lysholm中位评分明显更高（分别为97.9和93.4）。另外3例膝关节ACI患者供体部位活检的国际软骨修复学会（ICRS） II平均组织学评分为117±10（最高评分为140）。这项研究表明，至少在软骨摘取后5年内，ACI的软骨摘取部位与显著的关节发病率无关。然而，人们应该仔细考虑软骨摘取的位置，因为这已被证明会长期影响膝关节功能。
To establish if harvesting cartilage to source chondrocytes for autologous chondrocyte implantation (ACI) results in donor site morbidity. Twenty-three patients underwent ACI for chondral defects of either the ankle or the hip. This involved cartilage harvest from the knee (stage I), chondrocyte expansion in the laboratory and implantation surgery (stage II) into the affected joint. Prior to chondral harvest, no patient had sought treatment for their knee. Lysholm knee scores were completed prior to chondral harvest and annually post-ACI. Histological analyses of the donor site were performed at 12.3 ± 1.5 months for 3 additional patients who had previously had ACI of the knee. The median preoperative Lysholm score was 100, with no significant differences observed at either 13.7±1.7 months or 4.8±1.8 years postharvest (median Lysholm scores 91.7 and 87.5, respectively). Patients whose cartilage was harvested from the central or medial trochlea had a significantly higher median Lysholm score at latest follow-up (97.9 and 93.4, respectively), compared with those taken from the intercondylar notch (median Lysholm score 66.7). The mean International Cartilage Repair Society (ICRS) II histological score for the biopsies taken from the donor site of 3 additional knee ACI patients was 117 ± 10 (maximum score 140). This study suggests that the chondral harvest site in ACI is not associated with significant joint morbidity, at least up to 5 years postharvest. However, one should carefully consider the location for chondral harvest as this has been shown to affect knee function in the longer term.