Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus mosaicplasty for symptomatic articular cartilage lesions of the knee
Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus mosaicplasty for symptomatic articular cartilage lesions of the knee
复制标题
DOI：
10.1302/0301-620x.94b4.27495
复制
发表时间：
2012-04-01
影响因子：
--
通讯作者：
Carrington, R. W. J.
中科院分区：
文献类型：
--
作者：
Bentley, G.;Biant, L. C.;Carrington, R. W. J.
自体软骨细胞植入（ACI）和镶嵌成形术是治疗膝关节症状性关节软骨缺损的方法。这项研究代表了100名患者在至少10年的随访中首次长期随机比较两种技术。手术时患者的平均年龄为31.3岁（16 - 49岁）;术前症状的平均持续时间为7.2年（9个月至20年）。ACI组的病变较大，平均尺寸为440.9 mm（2）（100 - 1050），镶嵌成形术组为399.6 mm（2）（100 - 2000）。患者平均有1.5次（0 ~ 4次）关节软骨缺损手术史。使用改良的辛辛那提膝关节评分和Stanmore-Bentley功能评分系统对患者进行评估。术后10年，ACI组58例患者中有10例（17%）修复失败，而镶嵌成形术组42例患者中有23例（55%）修复失败（p <0.001）。
Autologous chondrocyte implantation (ACI) and mosaicplasty are methods of treating symptomatic articular cartilage defects in the knee. This study represents the first long-term randomised comparison of the two techniques in 100 patients at a minimum follow-up of ten years. The mean age of the patients at the time of surgery was 31.3 years (16 to 49); the mean duration of symptoms pre-operatively was 7.2 years (9 months to 20 years). The lesions were large with the mean size for the ACI group being 440.9 mm(2) (100 to 1050) and the mosaicplasty group being 399.6 mm(2) (100 to 2000). Patients had a mean of 1.5 previous operations (0 to 4) to the articular cartilage defect. Patients were assessed using the modified Cincinnati knee score and the Stanmore-Bentley Functional Rating system. The number of patients whose repair had failed at ten years was ten of 58 (17%) in the ACI group and 23 of 42 (55%) in the mosaicplasty group (p < 0.001).The functional outcome of those patients with a surviving graft was significantly better in patients who underwent ACI compared with mosaicplasty (p = 0.02).