Autologous chondrocyte implantation for traumatic large cartilage defect.
Autologous chondrocyte implantation for traumatic large cartilage defect.
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发表时间：
2007-07
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通讯作者：
Cholawish Chanlalit;Channarong Kasemkijwattanamd;Vithaya Varavit
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作者：
Cholawish Chanlalit;Channarong Kasemkijwattanamd;Vithaya Varavit
目的报告自体软骨细胞植入（ACI）术后即刻（6个月）的MRI临床和解剖结果。这是国内首次报道ACI提供软骨细胞。材料与方法ACI分两个阶段进行，第一阶段通过关节镜采集软骨并检测病理。根据ICRS，作者发现4级深层软骨缺损，面积2.5 cm 2，几乎完全撕裂半月板。进行半月板修复和软骨刮除。在此阶段收获300 mg软骨。4周后，进行了第二次ACL。使用外侧髌骨旁。骨膜用作软骨细胞悬浮液，并通过缝合到健康软骨，在注射细胞后使用Prolene间断缝合结合纤维蛋白胶密封囊袋。在第2天开始活动范围锻炼，并辅以持续被动运动机。跑步和跳跃被限制了9个月。结果无并发症发生，术后7-8周可完全活动和行走。视觉模拟评分从3分改善为0分。MRI显示缺损部位修复组织100%填充的证据，与软骨表面上方修复组织肥大相关。结论急性脑梗死的近期疗效与MRI所显示的临床和解剖学特征相一致。需要进一步随访和病例系列
OBJECTIVE The authors report the immediate result (6 months) after Autologous Chondrocyte Implantation (ACI) in clinical and anatomic result with MRI. This is the first report ofACI that provides chondrocyte cells from a domestic lab. MATERIAL AND METHOD ACI was done in a two-stage procedure, first stage via arthroscope to harvest cartilage and detect pathology. The authors found deep cartilage defect at grade 4 according ICRS, area 2.5 cm2 and near total meniscus tear. Meniscal repair and cartilage shaving were done. Harvesting 300 mg of cartilage was done in this stage. Four weeks later, the secondACl was done. Lateral para-patellar was used. Periosteum was used as chondrocyte suspension and by suture to the healthy cartilage, using prolene interrupted suture in conjunction with fibrin glue to seal the pocket after injecting the cell. Range of motion exercise started on day 2, assisted with continuous passive motion machine. Running and jumping were restricted for 9 months. RESULTS No complication was found, full range of motion and walking was done at 7-8 weeks post operative. Visual analogue scale improved from 3 points to 0 point. MRI shows evidence of 100% filling of the repair tissue in defect site associated with hypertrophy of the repair tissue above chondral surface. CONCLUSION Immediate result of ACI shows improvement in clinical and anatomic that present with MRI. Further follow up and case series is needed