[Arthroscopic tissue engineering scaffold repair for cartilage injuries].

Q3 Medicine
北京大学学报(医学版) Pub Date : 2025-04-18
Zhenlong Liu, Zhenchen Hou, Xiaoqing Hu, Shuang Ren, Qinwei Guo, Yan Xu, Xi Gong, Yingfang Ao
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引用次数: 0

Abstract

Objective: To standardize the operative procedure for tissue-engineered cartilage repair, by demonstrating surgical technique of arthroscopic implantation of decalcified cortex-cancellous bone scaffolds, and summarizing the surgical experience of the sports medicine department team at Peking University Third Hospital.

Methods: This article elaborates on surgical techniques and skills, focusing on the unabridged implantation technology and surgical procedure of decalcified cortex-cancellous bone scaffolds under arthroscopy: First, the patient was placed in the supine position. After anesthesia had been established, the surgeon established an arthroscope and explored the damaged area under the scope. After confirming the size and location of the injury site, the surgeon cleaned the damaged cartilage, and also trimmed the edges of the cartilage to ensure that the cut surface was smooth and stable. the surgeon performed the micro-fracture surgery in the area of cartilage injury, and then measured the size of the injured area under the scope. Next, the surgeon manually trimmed the tissue-engineered scaffold based on the measurements taken under the arthroscope, and then directly implanted the scaffold using a sleeve. A honeycomb-shaped fixator was used to implant absorbable nails to fix the scaffold. After the scaffold was installed, the knee was repeatedly flexed and extended for 10-20 times to ensure stability and range of motion. Finally, the arthroscope was withdrawn and the wound was closed.

Results: Decalcified cortex-cancellous bone scaffolds possessed unparalleled advantages over synthetic materials in terms of morphology and biomechanics. The cancellous bone part of the scaffold provided a three-dimensional, porous space for cell growth, while the cortical bone part offered the necessary mechanical strength. The surgery was performed entirely under arthroscopy to minimize invasiveness to the patient. Absorbable pins were used for fixation to ensure the stability of the scaffold. This technique could effectively improve the prognosis of the patients with cartilage injuries and standardized the surgical procedures for arthroscopic tissue-engineered scaffold operations in the patients with cartilage damage.

Conclusion: With the standard arthroscopic tissue-engineered scaffold repair technique, it is possible to successfully repair damaged cartilage, alleviate symptoms in the short term, and provide a more ideal long-term prognosis. The author and their team explain the surgical procedures for tissue-engineered scaffolds under arthroscopy, with the aim of guiding future clinical practice.

关节镜下组织工程支架修复软骨损伤
目的:通过展示关节镜下脱钙皮质-松质骨支架植入的手术技术,总结北京大学第三医院运动医学科团队的手术经验,规范组织工程软骨修复的手术流程。方法:本文阐述手术技术和技巧,重点介绍关节镜下脱钙皮质-松质骨支架的完整植入技术和手术步骤:首先,患者取仰卧位。麻醉建立后,外科医生建立了关节镜并在镜下探查损伤区域。在确认损伤部位的大小和位置后,外科医生对受损软骨进行清洗,并对软骨边缘进行修整,确保切割面光滑稳定。术者在软骨损伤区进行微骨折手术,并在镜下测量损伤区大小。接下来,外科医生根据关节镜下的测量结果手动修整组织工程支架,然后使用套管直接植入支架。采用蜂窝状固定架植入可吸收钉固定支架。支架安装后,反复屈伸膝关节10-20次,以保证膝关节的稳定性和活动范围。最后取出关节镜,缝合伤口。结果:脱钙皮质-松质骨支架在形态和生物力学方面具有合成材料无可比拟的优势。支架的松质骨部分为细胞生长提供了三维多孔空间,而皮质骨部分提供了必要的机械强度。手术完全在关节镜下进行,以尽量减少对患者的伤害。采用可吸收针固定,保证支架的稳定性。该技术可有效改善软骨损伤患者的预后,规范关节镜下软骨损伤患者组织工程支架手术的手术流程。结论:采用标准的关节镜下组织工程支架修复技术,可以成功修复受损软骨,短期内缓解症状,长期预后更理想。作者和他们的团队解释了关节镜下组织工程支架的手术步骤,旨在指导未来的临床实践。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
北京大学学报(医学版)
北京大学学报(医学版) Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
9815
期刊介绍: Beijing Da Xue Xue Bao Yi Xue Ban / Journal of Peking University (Health Sciences), established in 1959, is a national academic journal sponsored by Peking University, and its former name is Journal of Beijing Medical University. The coverage of the Journal includes basic medical sciences, clinical medicine, oral medicine, surgery, public health and epidemiology, pharmacology and pharmacy. Over the last few years, the Journal has published articles and reports covering major topics in the different special issues (e.g. research on disease genome, theory of drug withdrawal, mechanism and prevention of cardiovascular and cerebrovascular diseases, stomatology, orthopaedic, public health, urology and reproductive medicine). All the topics involve latest advances in medical sciences, hot topics in specific specialties, and prevention and treatment of major diseases. The Journal has been indexed and abstracted by PubMed Central (PMC), MEDLINE/PubMed, EBSCO, Embase, Scopus, Chemical Abstracts (CA), Western Pacific Region Index Medicus (WPR), JSTChina, and almost all the Chinese sciences and technical index systems, including Chinese Science and Technology Paper Citation Database (CSTPCD), Chinese Science Citation Database (CSCD), China BioMedical Bibliographic Database (CBM), CMCI, Chinese Biological Abstracts, China National Academic Magazine Data-Base (CNKI), Wanfang Data (ChinaInfo), etc.
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