软骨下成形术是一种新的微创手术技术,旨在治疗骨髓病变(BML)和早期骨关节炎(OA)。在手术过程中,工程磷酸钙化合物(CPC)注射。制造商声称,在愈合过程中,中国共产党被新的骨头取代。这项研究的目的是首次在人类中验证软骨下成形术后用新骨替代CPC。一名76岁的妇女因顽固性膝关节内侧疼痛而被转诊。站立X光片显示膝内翻OA,磁共振成像(MRI)显示BML。她接受了股骨内侧髁软骨下成形术。手术后获得了出色的疼痛缓解。之后,疼痛加重,X线照片证实了OA进展,患者在初次手术后4年接受了全膝关节置换术(TKA)治疗.对切除的骨进行组织学检查和显微计算机断层扫描(CT)检查。组织学上,皮质下骨的骨小梁嵌入无定形肿块中。然而,Micro-CT没有发现CPC吸收和/或骨置换的迹象。在短期内,软骨下成形术后,可以预期出色的疼痛缓解。然而,没有骨替代CPC,该技术可能不会影响膝关节OA的自然过程。
Subchondroplasty is a new minimally invasive surgical technique developed to treat bone marrow lesions (BML) and early osteoarthritis (OA). During the procedure, engineered calcium phosphate compound (CPC) is injected. It is claimed by the manufacturer that during the healing process, the CPC is replaced with new bone. The purpose of this study was to verify the replacement of CPC with new bone after subchondroplasty for the first time in humans. A 76-year old woman was referred for resistant medial knee pain. Standing radiographs showed varus knee OA and magnetic resonance imaging (MRI) revealed BML. She was treated with subchondroplasty of medial femoral condyle. Excellent relief of pain was achieved after procedure. Afterwards, the pain worsened, the radiographs confirmed the OA progression and the patient was treated with a total knee arthroplasty (TKA) 4 years after primary procedure. The resected bone was examined histologically and with micro-computed tomography (CT). Histologically, bone trabeculae of subcortical bone were embedded in the amorphous mass. However, no signs of CPC resorption and/or bone replacement have been found with micro-CT. In short term, excellent pain relief could be expected after the subchondroplasty procedure. However, there was no replacement of CPC with bone and the technique probably did not influence the natural process of knee OA.