Arthroscopic Knee Cartilage Repair With Covered Microfracture and Bone Marrow Concentrate
Arthroscopic Knee Cartilage Repair With Covered Microfracture and Bone Marrow Concentrate
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DOI：
10.1016/j.eats.2012.07.001
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发表时间：
2012-09-01
影响因子：
1.2
通讯作者：
Enea, Davide
中科院分区：
文献类型：
--
作者：
Gigante, Antonio;Cecconi, Stefano;Enea, Davide
近年来，一些单阶段软骨修复方法被设计用于治疗局灶性软骨病变。这些通常与微骨折（MFX）和覆盖支架相关。我们描述了一种结合MFX、自体骨髓浓缩物（BMC）和保护性支架的新型关节镜技术。从髂骨抽取骨髓离心得到BMC。清除软骨缺损，创建MFX孔，并使用弯曲的k线测量最终缺损。然后将支架塑形以匹配缺陷，浸入BMC中，用钳子插入关节，并用纤维蛋白胶和BMC的混合物固定在适当的位置。该技术旨在利用BMC中含有的大量间充质干细胞和生长因子来增强原始的单阶段手术，以增加缺陷填充和透明样软骨再生的速度。结合MFX、BMC和保护性支架的手术成本低廉，可重复性好，并且已经显示出再生透明状软骨的能力。它作为自体软骨细胞植入的替代方法还需要进一步的研究。
In recent years several single-stage cartilage repair approaches have been devised to treat focal cartilage lesions. These usually associate microfracture (MFX) and a coverage scaffold. We describe a novel arthroscopic technique that combines MFX, autologous bone marrow concentrate (BMC), and a protective scaffold. Bone marrow aspirate from the iliac crest is centrifuged to obtain BMC. The cartilage defect is debrided, MFX holes are created, and the final defect is measured by use of a bent K-wire. The scaffold is then shaped to match the defect, immersed in BMC, introduced into the joint with a grasper, and fixed in place with a mixture of fibrin glue and BMC. This technique aims to augment the original single-stage procedure with a number of mesenchymal stem cells and growth factors contained in the BMC, to increase the defect filling and the rate of hyaline-like cartilage regeneration. The procedure combining MFX, BMC, and a protective scaffold is inexpensive and reproducible and has already shown the ability to regenerate hyaline-like cartilage. Its use as an alternative to autologous chondrocyte implantation requires further investigation.