I型胶原基质植入与微骨折术治疗膝关节软骨缺损的临床与实验初步研究
简介
这项前瞻性、随机、单盲探索性 pilot 转化研究在18只大鼠全层软骨缺损模型和36例膝关节软骨缺损患者中比较I型胶原基质植入与微骨折术，患者随访12个月。动物实验12周时，I型胶原植入组的软骨及软骨下骨修复优于空白对照和微骨折组。临床中两组术后Lysholm和IKDC评分均显著改善，胶原组（n=20）在术后3、6、12个月的Lysholm、IKDC及MOC…
英文摘要
BACKGROUND Microfracture is used to treat cartilage defects but may compromise subchondral bone integrity. Type I collagen matrix implantation has emerged as a potential alternative for advanced (Outerbridge III-IV) lesions, although supporting evidence remains limited. This study combined clinical evaluation with an animal model to validate treatment outcomes. The aim was to compare short-term clinical efficacy and cartilage repair quality of Type I collagen matrix implantation versus microfracture and to validate clinical findings in an animal model. MATERIAL AND METHODS This prospective, randomized, exploratory pilot translational study included both animal and clinical experiments. Full-thickness cartilage defects were created in 18 rats and treated with a blank control, microfracture, or Type I collagen implantation. After 12 weeks, gross and histological evaluations (Safranin O/Fast Green staining) were performed. Concurrently, 36 patients with knee cartilage defects were enrolled in a randomized, single-blind trial (collagen group, n=20; microfracture group, n=16) and followed for 12 months. Lysholm, International Knee Documentation Committee (IKDC), and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scores were recorded preoperatively (Lysholm and IKDC only) and at 3, 6, and 12 months postoperatively. RESULTS In the animal model, Type I collagen implantation produced superior cartilage and subchondral bone repair compared with the control and microfracture groups. Clinically, both groups showed significant improvement; the collagen group consistently achieved higher functional and MOCART scores (P<0.05). CONCLUSIONS Type I collagen matrix implantation was associated with more favorable cartilage regeneration and better short-term clinical outcomes than microfracture, representing an effective biomaterial-assisted treatment strategy for knee cartilage defects.