{"title":"[Advances in clinical repair techniques for localized knee cartilage lesions].","authors":"Guangzhao Tian, Runmeng Li, Yongkang Yang, Chao Ning, Quanyi Guo","doi":"10.7507/1002-1892.202402056","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To summarize the classic and latest treatment techniques for localized knee cartilage lesions in clinical practice and create a new comprehensive clinical decision-making process.</p><p><strong>Methods: </strong>The advantages and limitations of various treatment methods for localized knee cartilage lesions were summarized by extensive review of relevant literature at home and abroad in recent years.</p><p><strong>Results: </strong>Currently, there are various surgical methods for treating localized knee cartilage injuries in clinical practice, each with its own pros and cons. For patients with cartilage injuries less than 2 cm <sup>2</sup> and 2-4 cm <sup>2</sup> with bone loss are recommended to undergo osteochondral autograft (OAT) and osteochondral allograft (OCA) surgeries. For patients with cartilage injuries less than 2 cm <sup>2</sup> and 2-4 cm <sup>2</sup> without bone loss had treatment options including bone marrow-based techniques (micro-fracture and ogous matrix induced chondrogenesis), autologous chondrocyte implantation (ACI)/matrix-induced ACI, particulated juvenile allograft cartilage (PJAC), OAT, and OCA. For patients with cartilage injuries larger than 4 cm <sup>2</sup> with bone loss were recommended to undergo OCA. For patients with cartilage injuries larger than 4 cm <sup>2</sup> without bone loss, treatment options included ACI/matrix-induced ACI, OAT, and PJAC.</p><p><strong>Conclusion: </strong>There are many treatment techniques available for localized knee cartilage lesions. Treatment strategy selection should be based on the size and location of the lesion, the extent of involvement of the subchondral bone, and the level of evidence supporting each technique in the literature.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 7","pages":"889-895"},"PeriodicalIF":0.0000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11252692/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"中国修复重建外科杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7507/1002-1892.202402056","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To summarize the classic and latest treatment techniques for localized knee cartilage lesions in clinical practice and create a new comprehensive clinical decision-making process.
Methods: The advantages and limitations of various treatment methods for localized knee cartilage lesions were summarized by extensive review of relevant literature at home and abroad in recent years.
Results: Currently, there are various surgical methods for treating localized knee cartilage injuries in clinical practice, each with its own pros and cons. For patients with cartilage injuries less than 2 cm 2 and 2-4 cm 2 with bone loss are recommended to undergo osteochondral autograft (OAT) and osteochondral allograft (OCA) surgeries. For patients with cartilage injuries less than 2 cm 2 and 2-4 cm 2 without bone loss had treatment options including bone marrow-based techniques (micro-fracture and ogous matrix induced chondrogenesis), autologous chondrocyte implantation (ACI)/matrix-induced ACI, particulated juvenile allograft cartilage (PJAC), OAT, and OCA. For patients with cartilage injuries larger than 4 cm 2 with bone loss were recommended to undergo OCA. For patients with cartilage injuries larger than 4 cm 2 without bone loss, treatment options included ACI/matrix-induced ACI, OAT, and PJAC.
Conclusion: There are many treatment techniques available for localized knee cartilage lesions. Treatment strategy selection should be based on the size and location of the lesion, the extent of involvement of the subchondral bone, and the level of evidence supporting each technique in the literature.
目的总结临床实践中膝关节软骨局部病变的经典和最新治疗技术,建立新的临床综合决策流程:方法:通过广泛查阅近年来国内外相关文献,总结膝关节软骨局部损伤各种治疗方法的优势和局限性:目前,临床上治疗膝关节软骨局部损伤的手术方法多种多样,各有利弊。对于软骨损伤小于 2 cm 2 和 2-4 cm 2 且伴有骨缺损的患者,建议进行骨软骨自体移植(OAT)和骨软骨异体移植(OCA)手术。对于软骨损伤小于2厘米2和2-4厘米2且无骨缺失的患者,可选择的治疗方法包括骨髓技术(微骨折和基质诱导软骨生成)、自体软骨细胞植入(ACI)/基质诱导ACI、颗粒状幼年异体软骨(PJAC)、OAT和OCA。对于软骨损伤大于 4 cm 2 并伴有骨缺失的患者,建议进行 OCA。对于软骨损伤大于4厘米2且无骨缺失的患者,治疗方案包括ACI/基质诱导ACI、OAT和PJAC:结论:膝关节软骨局部损伤有多种治疗技术可供选择。治疗策略的选择应基于病变的大小和位置、软骨下骨的受累程度以及文献中支持每种技术的证据水平。