A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee
A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee
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DOI：
10.1302/0301-620x.85b2.13543
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发表时间：
2003-03-01
影响因子：
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通讯作者：
Pringle, J
中科院分区：
文献类型：
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作者：
Bentley, G;Biant, LC;Pringle, J
自体软骨细胞植入（ACI）和镶嵌成形术都据称成功地修复了膝盖关节软骨的缺陷，但对这两种方法没有比较研究。总共100例平均年龄为31.3岁（16至49岁）的患者，膝盖中关节软骨的有症状病变，适合软骨修复，以随机进行ACI或成体成形术； 58例患者患有ACI和42个骨成形术。大多数病变是创伤后，缺陷的平均大小为4.66 cm（2）。症状的平均持续时间为7。2年，不包括关节镜检查的先前手术的平均数量为1.5。平均随访时间为19个月（12至26个）。使用改良的辛辛那州和斯坦莫尔评分进行官能评估，并且客观的临床评估表明，ACI后88％的效果良好或良好，而肉骨化成形后的效果很好，为69％。 ACI后82％的关节镜检查表现出82％的良好或良好的维修，而在镶嵌成年后的34％。我们的前瞻性，随机，临床试验均显示出ACI优于骨膜成形术，用于修复膝关节中关节缺陷的所有五个tellar骨膜片代表。 ACI的结果与其他研究中的结果相当，但是镶嵌成形术的结果表明其持续使用具有可疑价值。
Autologous chondrocyte implantation (ACI) and mosaicplasty are both claimed to be successful for the repair of defects of the articular cartilage of the knee but there has been no comparative study of the two methods. A total of 100 patients with a mean age of 31.3 years (16 to 49) and with a symptomatic lesion of the articular cartilage in the knee which was suitable for cartilage repair was randomised to undergo either ACI or mosaicplasty; 58 patients had ACI and 42 mosaicplasty. Most lesions were post-traumatic and the mean size of the defect was 4.66 cm(2). The mean duration of symptoms was 7.2 years and the mean number of previous operations, excluding arthroscopy, was 1.5. The mean follow-up was 19 months (12 to 26).Functional assessment using the modified Cincinatti and Stanmore scores and objective clinical assessment showed that 88% had excellent or good results after ACI compared with 69% after mosaicplasty. Arthroscopy at one year demonstrated excellent or good repairs in 82% after ACI and in 34% after mosaicplasty. All five patellar mosaicplasties failed.Our prospective, randomised, clinical trial has shown significant superiority of ACI over mosaicplasty for the repair of articular defects in the knee. The results for ACI are comparable with those in other studies, but those for mosaicplasty suggest that its continued use is of dubious value.