基质诱导自体软骨细胞移植术治疗距骨软骨损伤临床疗效观察

doi:10.13418/j.issn.1001-165x.2019.01.019

Abstract

Abstract:

Objective　To evaluate clinical outcomes of Matrix-induced autologous chondrocyte implantation (MACI) in the treatment of talus cartilage defects.　Methods　From March 2012 to September 2014, a retrospective analysis of MACI was performed on eleven patients who had sustained talus cartilage lesion. 17 cases (12 male and 5 female) were enrolled into the study with a mean age of (32.6±1.4) years old ( ranging from 21 to 48 years old) and a mean defective area of (3.4±0.8) cm2( ranging from 1.6 to 5.8 cm2). Hepple classification: 5 cases of HeppleⅠ，9 cases of HeppleⅡ and 3 cases of Hepple Ⅲ. Arthroscopy, debridement and cartilage harvesting procedure were performed in the first operation. After 2 to 4 weeks of preparation of tissue engineering cartilage, autologous grafting and sealing of the defect with fibrin glue were performed. All patients were regularly followed up. VAS score, AOFAS score and magnetic resonance observation of cartilage repair tissue ( MOCART) were adopted for assessment of clinical outcomes.　Results All surgeries were performed successfully with a mean follow-up time of (52.3±5.6 ) months( ranging from 38 to 72 months). The VAS score, AOFAS score and MOCART score at the final follow-up were significantly improved compared with those prior to operation, i.e, (0.8±0.6) vs (7.8±1.4) points, (94.8±1.9)vs(69.2± 2.7) points, (6.5± 0.4)vs(3.6± 0.8) points, P<0.05). Complete filling of the defect at the level of the surrounding cartilage was found in 11 cases, and complete filling with a hypertrophic cartilage layer was found in 6 cases of the patients. Normal signal intensity of the repair tissue compared with the adjacent native cartilage was seen in 4 cases, with nearly normal activity in 13 cases.　Conclusions　MACI therapy for talus cartilage defects with normal subchondral bone can obtain good clinical outcomes, while the long term clinical outcomes remains to be seen.

Key words: Ankle joint, 　Talus, 　Cartilage lesions, 　Matrix-induced autologous chondrocyte implantation( MACI)

LIU Hai-feng, WU Bing, LIANG Da-qiang, LI Hao, LU Wei. Matrix-induced autologous chondrocyte implantation of talus cartilage defect[J]. Chinese Journal Of Clinical Anatomy, 2019, 37(1): 91-96.

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Matrix-induced autologous chondrocyte implantation of talus cartilage defect

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