Clinical feasibility of a novel biphasic osteochondral composite for matrix-associated autologous chondrocyte implantation
Clinical feasibility of a novel biphasic osteochondral composite for matrix-associated autologous chondrocyte implantation
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DOI：
10.1016/j.joca.2013.01.004
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发表时间：
2013-04-01
影响因子：
7
通讯作者：
Jiang, C. -C.
中科院分区：
文献类型：
--
作者：
Chiang, H.;Liao, C. -J.;Jiang, C. -C.
目的：基质相关的自体软骨细胞移植已被用于治疗软骨缺损。我们开发了一种双相圆柱形的骨软骨复合结构，并进行了这项研究，以确定其可行性，用于治疗骨软骨病变在人类knees.Method：10例有症状的骨软骨病变在股骨髁进行了治疗，通过更换病理组织与DL-聚乳酸-共-乙交酯，其下半身浸渍与D-磷酸三钙和骨相的建设。该结构具有装载双切碎的自体软骨的腔室，作为软骨细胞的来源。骨软骨损伤是钻成一个与结构尺寸相同的凹坑。将载有软骨细胞的结构压配以填充凹坑。使用膝关节损伤和骨关节炎结局评分（KOOS）量表评价术后结局，直至24个月。在12个月时进行磁共振成像，并通过第二次关节镜穿刺活检收集样本组织。结果：主要是手术的安全性，其次是术后KOOS的变化以及透明软骨和松质骨的再生。术后“症状”子量表的平均KOOS与术前相比直到24个月没有显著变化;而其他四个子量表的平均KOOS在12个月和24个月时显著高于术前。二次关节镜检查显示移植部位完全填充，再生软骨表面与周围天然关节表面齐平。结论：这种新型的软骨细胞植入支架在膝关节手术中应用是安全的。它通过透明软骨的成功再生来修复股骨髁的骨软骨损伤。(C)2013年国际骨关节炎研究学会。由爱思唯尔有限公司出版。保留所有权利。
Objective: Matrix-associated autologous chondrocyte implantation has been used to treat cartilage defects. We developed a biphasic cylindrical osteochondral composite construct for such use, and conducted this study to determine its feasibility for treating osteochondral lesions in human knees.Method: Ten patients with symptomatic osteochondral lesions at femoral condyles were treated by replacing pathological tissue with the construct of DL-poly-lactide-co-glycolide, whose lower body was impregnated with D-tricalcium phosphate and served as osseous phase. The construct had a chamber to load double-minced autologous cartilage, serving as source of chondrocytes. Osteochondral lesion was drill-fashioned a pit of identical dimension as the construct. Chondrocyte-laden construct was press-fit to fill the pit. Postoperative outcome was evaluated using Knee Injury and Osteoarthritis Outcome Score (KOOS) scale up to 24 months. Magnetic resonance image was taken, and sample tissue was collected with second-look arthroscopic needle biopsy at 12 months. Outcome parameters were primarily safety of surgery, and secondarily postoperative change in KOOS and regeneration of hyaline cartilage and cancellous bone.Results: No patient experienced serious adverse events. Postoperative mean KOOS in "symptoms" subscale had not changed significantly from pre-operation until 24 months; whereas those in the other four subscales were significantly higher than pre-operation at 12 and 24 months. Second-look arthroscopy showed completely filled grafted sites, with regenerate cartilaginous surfaces flushed with surrounding native joint surface. Microscopically, regenerated cartilage appeared hyaline.Conclusion: This novel construct for chondrocyte implantation is safe for surgical application in knee. It repairs osteochondral lesions of femoral condyles by successful regeneration of hyaline cartilage. (C) 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.