Biological, functional and radiographic evaluation of autologous chondrocyte implantation

自体软骨细胞植入的生物学、功能和放射学评估

• 批准号: nhmrc : 254743
• 负责人: Prof David Wood
• 金额: $ 20.5万
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Development Grants
• 财政年份: 2003
• 资助国家: 澳大利亚
• 起止时间: 2003-01-01 至 2005-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/biological-functional-radiographic-chondrocyte-implantation/97059
• 关键词: Biological; functional; radiographic; evaluation; autologous

We will test the hypothesis that autologous chondrocyte implantation (ACI) and extensor realignment produces superior clinical, biological and radiographic results when compared with conventional treatment of realignment and debridement. We will specifically address the following aims: 1. Quantify the clinical outcome of ACI compared to the traditionally used treatment of debridement through the use of functional evaluation in a blinded randomised controlled clinical trial; 2. Evaluate the radiographic changes in the patellofemoral joint that occur as a result of ACI, using high resolution magnetic resonance imaging (MRI) to quantify the regeneration of hyaline articular cartilage; 3. Using the new technique of confocal arthroscopy, we will compare the histologic appearances of the ACI graft and its interface with adjacent articular cartilage; 4. Evaluate patient, surgical and explant chondrocyte characteristics in relation to functional, radiographic and biological outcomes. With respect to the matrix-induced autologous chondrocyte implantation (MACI) technique, we wish to clarify the clinical practice as a definitive treatment for articular cartilage defects. This will be the first randomised, controlled clinical trial of the MACI technique compared to that used by other groups. A positive clinical outcome from this trial will help promote the three cornerstones of this procedure – successful cell culture, efficient surgical procedures, and complimentary postoperative rehabilitation. Furthermore, this research will: a) Enhance the expansion of the MACI technique; b) Encourage development of endoscopic techniques of implantation using a combination of – • Preoperative defect registration with MRI • pre-cut custom patches, implanted with • Computer-assisted navigation techniques: c) Increase the potential to cater for a larger number of patients requiring articular cartilage repair; d) Confirm the long-term durability of regenerated cartilage in the 4th year and beyond; e) Add further commercial value by demonstrating MACI may prevent the onset of osteoarthritis.

我们将验证这样一种假设，即与传统的软骨细胞植入和清创治疗相比，自体软骨细胞植入(ACI)和伸肌重建术可以产生更好的临床、生物学和放射学结果。我们将具体解决以下目标：1.在盲法随机对照临床试验中，通过使用功能评估来量化ACI与传统清创治疗相比的临床结果；2.使用高分辨率磁共振成像(MRI)来量化ACI引起的髌股关节的放射学变化，以量化透明关节软骨的再生；3.使用新的共焦关节镜技术，我们将比较ACI移植物的组织学外观及其与邻近关节软骨的界面；4.评估患者、手术和移植的软骨细胞特征与功能、放射学和生物学结果的关系。关于基质诱导自体软骨细胞植入(MACI)技术，我们希望阐明其作为关节软骨缺损的最终治疗方法的临床实践。这将是与其他小组使用的技术相比，MACI技术的第一次随机对照临床试验。这项试验的积极临床结果将有助于促进这一过程的三个基石--成功的细胞培养、高效的外科手术和免费的术后康复。此外，这项研究将：a)加强MACI技术的扩展；b)结合使用以下技术来鼓励内窥镜植入技术的发展：·术前通过MRI登记缺陷·预先切割定制补片，植入·计算机辅助导航技术：c)增加满足更多需要关节软骨修复的患者的潜力；d)确认再生软骨在第4年及以后的长期耐久性；e)通过证明MACI可以防止骨关节炎的发生，增加进一步的商业价值。