[Treatment of cartilaginous defects in the knee: recommendations from the Dutch Orthopaedic Association].
[Treatment of cartilaginous defects in the knee: recommendations from the Dutch Orthopaedic Association].
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DOI：
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发表时间：
2013
影响因子：
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通讯作者：
M. H. van der Linden;D. Saris;S. Bulstra;P. Buma
中科院分区：
文献类型：
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作者：
M. H. van der Linden;D. Saris;S. Bulstra;P. Buma
膝关节软骨缺损是一种常见的疾病，可给患者带来相当大的限制。通过MRI和关节镜检查对其进行诊断和分类。可用于治疗深部软骨病变的手术选择包括骨髓刺激技术（微骨折治疗）、软骨细胞疗法（自体软骨细胞植入）和组织替代疗法（骨软骨自体移植）。微骨折治疗和骨软骨自体移植分别适用于治疗延伸至软骨下骨且小于2和4 cm 2的软骨病变。自体软骨细胞植入是治疗50岁以下成人大于2 cm 2的单一症状性软骨病变的合适方法。微骨折治疗、自体软骨细胞植入和骨软骨自体移植治疗小缺损的有效性无显著差异：均显示出良好的临床和功能性短期和中期结果。与微骨折治疗相比，新的第二代和第三代自体软骨细胞植入技术似乎对大于4 cm 2的病变产生更可持续的组织修复和更好的临床长期结果。
Cartilaginous defects in the knee occur frequently and can cause the patient considerable limitations. They are diagnosed and classified by means of MRI and arthroscopy. The surgical options available to treat deep chondral lesions include bone marrow stimulation techniques (microfracture treatment), chondrocyte therapies (autologous chondrocyte implantation) and tissue replacement therapies (osteochondral autologous transplantation). Microfracture treatment and osteochondral autologous transplantation are suitable for treating chondral lesions that extend to the subchondral bone and are smaller than 2 and 4 cm2, respectively. Autologous chondrocyte implantation is a suitable method for treating single symptomatic chondral lesions larger than 2 cm2 in adults up to 50 years of age. There are no significant differences regarding the effectiveness of microfracture treatment, autologous chondrocyte implantation and osteochondral autologous transplantation for small defects: all show good clinical and functional short- and medium-term results. New second- and third-generation autologous chondrocyte implantation techniques seem to yield more sustainable tissue repair and better clinical long-term results for lesions larger than 4 cm2 in comparison to microfracture treatment.