Successful osteoconduction but limited cartilage tissue quality following osteochondral repair by a cell-free multilayered nano-composite scaffold at the knee
Successful osteoconduction but limited cartilage tissue quality following osteochondral repair by a cell-free multilayered nano-composite scaffold at the knee
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DOI：
10.1007/s00264-016-3118-2
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发表时间：
2016-03-01
影响因子：
2.7
通讯作者：
Trattnig, Siegfried
中科院分区：
文献类型：
--
作者：
Brix, Martin;Kaipel, Martin;Trattnig, Siegfried
介绍膝关节较大骨软骨病病变的治疗仍然是一个临床挑战。一个有前途的策略，以克服这个问题可能是外科手术修复，通过使用无细胞的多层纳米复合scaffold.Method在这个前瞻性队列研究8例连续患有一个单一的骨软骨损伤（>= 1.5 cm（2））的股骨髁。在术后18个月时，使用基于MRI的生化MR序列（T2标测）以及半定量形态学分析（MOCART评分）评估植入物的修复潜力。在6个月，12个月，18个月和24个月的随访结果，通过使用IKDC，Tegner-Lysholm，和辛辛那提膝关节scores.Results的8例患者中有7例显示了一个完整的整合到边界区的支架和5个8例优秀或良好的软骨下骨化的种植体在18个月后植入。在所有8名患者中发现修复组织的表面是完整的。与健康对照软骨相比，修复组织中的T2映射数据和带状T2指数显著不同（P <0.001），这表明修复软骨的质量有限。结论通过植入MaioRegenA（R）支架进行骨软骨修复，可成功地进行骨传导并填充软骨缺损。然而，有证据表明，在手术后18个月，修复软骨组织质量有限。
Introduction The treatment of larger osteochondral lesions in the knee is still a clinical challenge. One promising strategy to overcome this problem could be surgical repair by using a cell-free multilayered nano-composite scaffold.Method In this prospective cohort study eight consecutive patients which suffered from a single osteochondral lesion (>= 1.5 cm(2)) on the femoral condyle were enrolled. The repair potential of the implant was assessed by using MRI based biochemical MR sequences (T2 mapping) as well as semi-quantitative morphological analyses (MOCART score) at 18 months after the surgery. The clinical outcome was determined at six, 12, 18, and 24 month follow ups by using IKDC, Tegner-Lysholm, and Cincinnati knee scores.Results Seven out of eight patients showed a complete integration of the scaffold into the border zone and five out of eight patients excellent or good subchondral ossification of the implant at 18 months following implantation. The surface of the repair tissue was found to be intact in all eight patients. T2 mapping data and the zonal T2 index significantly differed in the repair tissue compared to the healthy control cartilage (P < 0.001) which indicates a limited quality of the repair cartilage. The clinical outcome scores consistently improved during the follow up period without reaching statistical significance.Conclusions Osteochondral repair by implanting the MaioRegenA (R) scaffold provides a successful osteoconduction and filling of the cartilage defect. However there is evidence for a limited repair cartilage tissue quality at 18 months after the surgery.