自体软骨细胞移植技术治疗膝关节软骨缺损的研究进展

膝关节软骨缺损发病率高,且自身修复能力有限。治疗膝关节软骨缺损的传统方法包括钻孔术、微骨折术、自体骨软骨移植术。然而,钻孔术和微骨折术治疗后缺损区生成的是纤维软骨,而不是正常的透明软骨,两者在力学强度、硬度、耐磨损性等多方面存在很大差距。自体骨软骨移植术可生成正常的透明软骨,但存在供体有限、不适合进行大面积软骨缺损治疗等多方面缺点在临床方面应用受限。近年来,自体软骨细胞移植技术发展迅速,越来越多的病人接受此治疗方法并获得良好效果,引起人们广泛关注。本文根据近年来国内外的各项相关研究成果进行总结,阐述膝关节软骨缺损的各种治疗方法,着重介绍自体软骨细胞移植技术。第三代自体软骨细胞移植技术生成的软骨以透明软骨为主,符合关节生物力学要求,且避免了第一代、第二代自体软骨细胞移植的术后并发症,成为治疗膝关节大面积软骨缺损安全有效的治疗方法。另外,本文就软骨细胞支架材料的发展、移植物术后的转归等问题提出进一步设想。

The Current of Treatment for Cartilage Defects in the Knee with AutologousChondrocyte Implantation

The cartilage defects in the knee has substantial morbidity and a limited capacity for self-repair. The traditionaltreatment for cartilage defects in the knee include:drilling,microfracture,mosaicplasty. After the drilling and microfracture, defect areagenerated is fibrocartilage, rather than the normal hyaline cartilage, mechanical strength, hardness, wear resistance between the two typethere is a big gap in many aspects.The clinical application of mosaicplasty restricted by donor limited, not suitable for large cartilagedefect treatment, although it can generate normal hyaline cartilage. In recent years, autologous chondrocyte implantation has developedrapidly, a growing number of patients receiving this treatment method and obtain good or excellent effect, caused widespread concern.This review summarized recent studies, introduce various treatment strategy especially for autologous chondrocyte implantation.The thirdgeneration of ACT generated cartilage is hyaline cartilage that conform to the requirements of the joint biomechanics, and avoid thepostoperative complications created by first generation and second generation of ACT. ACT was a safe and effective treatment for largecartilage defect in knee joint. In addition, our review assumed new directions for further reaserch about cartilage scaffold materials andgraft transformation postoperative.