Surgical treatment of chondral knee defects using a collagen membrane – autologus matrix-induced chondrogenesis

Diego Costa Astur, Jonathas Costas Lopes, Marcelo Abdulklech Santos, Camila Cohen Kaleka, Joicemar Tarouco Amaro, Moises Cohen
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引用次数: 13

Abstract

Objectives

To evaluate the clinical and functional results of patients diagnosed with full-thickness chondral defects on symptomatic knees who underwent a biological repair technique using autologous matrix-induced chondrogenesis.

Methods

Seven patients who underwent surgical treatment due to chondral lesions in the knee by autologous matrix-induced chondrogenesis were evaluated. The Lysholm, Kujala and visual analog scale of pain questionnaires were applied before and 12 months after the surgery. Nuclear magnetic resonance images were evaluated 12 months after surgery according to MOCART (magnetic resonance observation of cartilage repair tissue) cartilage repair tissue score.

Results

Of the seven patients evaluated, three presented defects classified as grade III and four as grade IV according to the International Cartilage Repair Society classification. Chondral defects were located in the medial femoral condyle (n = 2), patella (n = 2), and trochlea (n = 3). The mean age of the patients (six men and one woman) was 37.2 years (24–54 years). The mean chondral defect size was 2.11 cm2 (1.0–4.6 cm2). After 12 months, post-operative nuclear magnetic resonance showed resurfacing of the lesion site with scar tissue less thick than normal cartilage in all patients. The mean MOCART score was 66.42 points. A significant decrease in pain and an improvement in the Lysholm and Kujala scores were observed.

Conclusion

The use of the collagen I/III porcine membrane was favorable for the treatment of chondral and osteochondral lesions of the knee when assessing the results using the VAS, Lysholm, and Kujala scores 1 year after surgery, as well as when assessing the magnetic resonance image of the lesion 6 months after surgery.

Abstract Image

Abstract Image

利用胶原膜-自体基质诱导软骨形成的手术治疗膝关节软骨缺损
目的评价有症状膝关节全层软骨缺损患者采用自体基质诱导软骨形成的生物修复技术的临床和功能效果。方法对7例膝关节软骨病变行自体基质诱导软骨形成手术治疗的患者进行回顾性分析。术前和术后12个月分别采用Lysholm、Kujala和视觉模拟疼痛量表。术后12个月,根据MOCART (magnetic resonance observation of cartilage repair tissue)软骨修复组织评分评估核磁共振图像。结果7例患者中,3例按照国际软骨修复学会分级为III级,4例为IV级。软骨缺损位于股骨内侧髁(n = 2)、髌骨(n = 2)和滑车(n = 3)。患者平均年龄(6男1女)37.2岁(24-54岁)。软骨缺损平均大小为2.11 cm2 (1.0 ~ 4.6 cm2)。12个月后,术后核磁共振显示所有患者病变部位的瘢痕组织厚度小于正常软骨。MOCART平均评分66.42分。疼痛明显减轻,Lysholm和Kujala评分明显改善。结论应用I/III型胶原猪膜治疗膝关节软骨和骨软骨病变,术后1年采用VAS评分、Lysholm评分、Kujala评分进行评价,术后6个月采用磁共振成像进行评价,均有利于治疗膝关节软骨和骨软骨病变。
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