膝关节软骨修复和关节保护的新一代方法

José Rafael García , Alexander J. Acuña , Juan Bernardo Villareal , Rodrigo Saad Berreta , Salvador Gonzalez Ayala , Laura del Baño-Barragán , Felicitas Allende , Jorge Chahla
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引用次数: 0

摘要

导言关节软骨在保持膝关节结构完整性方面起着至关重要的作用。损伤可表现为局灶性软骨缺损或进行性骨关节炎。膝关节软骨损伤的治疗方法是多方面的,包括手术和非手术干预,以修复缺损、缓解症状、恢复功能和延缓疾病进展。方法总结了手术和非手术膝关节软骨修复和关节保护疗法的适应症、结果和生物学特征。结果骨软骨自体移植和骨软骨异体移植提供了持久的解决方案,具有良好的长期疗效。自体软骨细胞植入术和基质诱导自体软骨细胞植入术是先进的细胞疗法,对较大的缺损有效,尤其适用于年轻、好动的人。透明质酸等非手术疗法可缓解膝关节骨关节炎的症状。骨髓抽吸物浓缩物和富血小板血浆在缓解症状和改善关节功能方面具有疗效,是一种微创方法,在膝关节保存和软骨修复方面具有良好的效果。虽然最近的文献显示了令人鼓舞的结果,但现有的高级别证据仍然有限。随着医学从业者将重点转向下一波膝关节软骨修复和关节保护方法,新出现的证据让人对未来充满乐观。然而,要对现有各种治疗方法的效果、安全性和有效性进行比较,全面的研究是必不可少的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
New horizons in cartilage repair: update on treatment trends and outcomes

Introduction

Articular cartilage plays a crucial role in preserving the knee joint's structural integrity. Damage can manifest as focal chondral defects or progressive osteoarthritis. Treatment options for knee cartilage damage are multifaceted, encompassing surgical and nonsurgical interventions to repair defects, alleviate symptoms, restore function, and slow disease progression.

Objectives

Gain insight and summarize the latest available evidence of knee joint preservation techniques.

Methods

The indications, outcomes, and biological characteristics of operative and nonoperative knee cartilage repair and joint preservation therapies were summarized.

Results

Osteochondral autologous transplantation and osteochondral allograft transplantation offer durable solutions with excellent long-term outcomes. Autologous chondrocyte implantation and matrix-induced autologous chondrocyte implantation are advanced, cell-based therapies effective for larger defects, especially in younger, active individuals. Non-operative therapies such as hyaluronic acid provide symptomatic relief for knee osteoarthritis. Bone marrow aspirate concentrate and platelet-rich plasma show efficacy in alleviating symptoms and improving joint function, presenting a minimally invasive approach with promising results for knee preservation and cartilage repair.

Conclusion

The use of minimally invasive and nonsurgical interventions in addressing focal cartilage defects, osteoarthritis, and overall joint preservation has yielded varied results. Although recent literature has exhibited encouraging findings, the existing body of high-level evidence remains limited. The emerging evidence inspires optimism for the future, as medical practitioners shift focus to the next wave of knee cartilage repair and joint preservation methodologies. However, comprehensive research is essential to establish conclusive insights into outcomes, safety profiles, and comparative effectiveness among the diverse available treatments.

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