目的:评估临床,射线照相,在5年的随访中,在10-mm深度的骨软骨缺损(OD)中,肋软骨细胞衍生的颗粒型无支架自体软骨细胞植入(CCP-ACI)的磁共振(MR)结果。
方法:回顾性分析10例CCP-ACI患者行ODs,深度达10mm。最短随访期为5年。中位年龄为36.5(范围20-55)岁。OD病变的中值大小和深度分别为4.25cm2(范围2-6)和7.0mm(6-9),分别。临床上,国际膝关节文献委员会,Lysholm,和视觉模拟量表疼痛评分进行评估。射线照相,评估了髋-膝-踝(HKA)角度和Kellgren-Lawrence(K-L)等级。在MR成像上,磁共振观察软骨修复组织(MOCART)2.0评分及缺损深度。
结果:术后1年、2年和5年,所有平均临床评分均显著改善。平均HKA角度和K-L等级比例在5年内没有明显变化。MOCART总分中位数为50分(45-65分),50(35-90),57.5(40-90),和65(50-85)在6个月,1年,2年,术后5年,分别(p=0.001),与术后6个月相比,2年显着改善。修复组织和软骨下变化的信号强度从10(范围10-10)显着提高到12.5(10-15)(p=0.036),从10(10-10)到17.5(0-20)(p=0.017),分别。前者在术后5年发现显着改善,后者在术后2年发现显着改善。术前和6个月MR成像的平均深度分别为6.7、6.7、6.8、6.6和6.6mm,1年,2年,术后5年无明显变化(n。s).
结论:CCP-ACI在没有植骨的情况下,在ODs深度达10-mm的情况下提供了可接受的中期结果。该程序可以是没有支架相关问题的OD的微创治疗选择之一。
方法:IV.
OBJECTIVE: To evaluate clinical, radiographic, and magnetic resonance (MR) results of costal chondrocyte-derived pellet-type scaffold-free autologous chondrocyte implantation (CCP-ACI) in osteochondral defects (ODs) up to 10-mm depth during 5 years of follow-up.
METHODS: Ten patients with CCP-ACI performed in ODs with depth up to 10 mm were retrospectively analyzed. The minimum follow-up period was 5 years. The median age was 36.5 (range 20-55) years. The median size and the depth of the OD lesion were 4.25 cm2 (range 2-6) and 7.0 mm (6-9), respectively. Clinically, the International Knee Documentation Committee, Lysholm, and visual analog scale pain scores were evaluated. Radiographically, the hip‒knee‒ankle (HKA) angle and the Kellgren‒Lawrence (K‒L) grade were assessed. On MR imaging, the magnetic resonance observation of cartilage repair tissue (MOCART) 2.0 score and the defect depth were evaluated.
RESULTS: All average clinical scores improved significantly by 1, 2, and 5 years postoperatively. The average HKA angle and the proportion of K‒L grade did not change significantly within 5 years. The median total MOCART scores were 50 (range 45-65), 50 (35-90), 57.5 (40-90), and 65 (50-85) at 6 months, 1 year, 2 years, and 5 years postoperatively, respectively (p = 0.001), with significant improvement at 2 years compared to that at 6 months postoperatively. The signal intensity of the repair tissue and subchondral change significantly improved from 10 (range 10-10) to 12.5 (10-15) (p = 0.036), and from 10 (10-10) to 17.5 (0-20) (p = 0.017), respectively. Significant improvements were seen at 5 years postoperatively for the former and at 2 years postoperatively for the latter. The average depths on MR imaging were 6.7, 6.7, 6.8, 6.6, and 6.6 mm preoperatively and at 6 months, 1 year, 2 years, and 5 years postoperatively with no significant changes (n.s).
CONCLUSIONS: CCP-ACI provided acceptable mid-term outcomes in ODs up to 10-mm in depth without bone grafting despite of no scaffold. The procedure can be one of minimally invasive treatment options for ODs without scaffold-related problems.
METHODS: IV.