Arthroscopic Abrasion Arthroplasty: A Review
Arthroscopic Abrasion Arthroplasty: A Review
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DOI：
10.1097/00003086-200110001-00028
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发表时间：
2001-10
影响因子：
4.2
通讯作者：
L. L. Johnson-L.
中科院分区：
文献类型：
--
作者：
L. L. Johnson-L.
关节镜下磨损关节成形术是对寻求全膝关节置换术替代方案的患者广泛的多组织清创术的详细描述。手术是治标不治本的。在寻求全膝关节置换术替代方案的患者中，大多数患者可能会避免或推迟长达5年的最终手术。由于手术的擦伤部分伴随着多种组织类型的清创，尚不清楚擦伤方面对临床有何益处。此外，还没有进行前瞻性随机临床研究，大多数临床医生报告了他们的手术经验，有不同的适应证、技术和/或术后治疗。未来的研究可能会回答这些临床问题。已知在磨损部位形成纤维软骨。修复组织具有软骨的许多特征，但不具有关节软骨的生物力学特性。纤维软骨已经显示出多年的耐久性，在机会性的第二次关节镜检查中得到证实。生长因子科学或基因工程的应用可能提供将磨损关节成形术的再生组织转化为成熟关节软骨的方法。
Arthroscopic abrasion arthroplasty is an elaborate description for an extensive multiple tissue debridement for patients seeking an alternative to total knee replacement. The operation is palliative, not curative. In patients seeking an alternative to total knee replacement, the definitive operation may be avoided or deferred in a high percentage of patients as many as 5 years. Because the abrasion portion of the operation is accompanied by multiple tissue type debridement, it is not known what clinical benefit the abrasion aspect contributes. Furthermore, no prospective randomized clinical studies have been done and most clinicians reporting on their experience with the procedure have varied the indications, technique, and/or postoperative treatment. Future investigation may answer these clinical questions. It is known that fibrocartilage forms at the abrasion site. The reparative tissue has many of the characteristics of cartilage, but does not have the biomechanical properties of articular cartilage. The fibrocartilage has shown durability for many years confirmed during opportunistic second look arthroscopy. The applications of growth factor science or genetic engineering may provide means of converting the regenerative tissue of abrasion arthroplasty to mature articular cartilage.