使用水凝胶支架（CaReS©）的自体软骨细胞移植治疗膝关节软骨缺损的7-12年临床随访
简介
一项针对胶原水凝胶支架自体软骨细胞移植（CaReS）治疗膝关节软骨缺损的中长期随访研究，纳入26例患者，中位随访12年。结果显示术后Lysholm评分（81.69）和改良Cincinnati评分（7.38）显著改善，主观IKDC评分64.80，MOCART 2.0评分53.33，患者满意度NRS 6.3，疼痛NRS 3.6。该技术可带来长期临床改善，但样本量…
英文摘要
BACKGROUND: Autologous chondrocyte implantation (ACI) procedures have improved the treatment of chondral lesions. AIM: To evaluate the clinical efficacy of an ACI technique utilizing a collagen 1‑based hydrogel as a 3D scaffold in mid-term to long-term follow-up. METHOD: In this study 44 patients were treated at a single, specialized center between 2006 and 2011. Of these 26 patients were included in the follow-up at a median of 12 years (SD ± 1.5 years). Of these, 12 cases of knee cartilage defects were assessed with the IKDC (International Knee Documentation Committee), ICRS (International Cartilage Regeneration & Joint Preservation Society), modified Cincinnati and TAS (Tegner Activity Scale) Scores. Another 6 of these agreed to a post-surgical magnetic resonance imaging (MRI) evaluation where the regenerated cartilage tissue was assessed via magnetic resonance observation of cartilage repair tissue (MOCART 2.0) score (median follow up 159.17 ± 20.9 months). Additionally, 14 patients were assessed via a telephone questionnaire assessing subjective patient satisfaction and pain on numeric rating scales (NRS) and the necessity for further surgery. RESULTS: The postoperative Lysholm score was 81.69 ± 11.39 (p < 0.05), and the modified Cincinnati score was 7.38 ± 1.89 (p < 0.001). Both scores improved significantly. The post-surgical subjective IKDC score was 64.80 ± 8.46 and the post-surgical TAS score was 4.23 ± 1.30. The MOCART 2.0 was 53.33 (± 17.51). The questionnaire resulted in 12 participants with no complications and 2 requiring a second surgery. Subjective satisfaction resulted in a mean NRS of 6.3 (± 3.4) and pain with 3.6 (± 2.2). CONCLUSION: The use of ACI utilizing a collagen 1‑based hydrogel as a 3D scaffold was shown to result in a significant improvement after a long-term follow-up of 12 (± 1.5) years with a good to moderate subjective satisfaction and low to moderate levels of pain.