{"title":"编辑评论:髋关节软骨修复的理想治疗方案仍然难以确定,需要考虑患者的个体因素。","authors":"Alexander Zimmerer","doi":"10.1016/j.arthro.2024.09.044","DOIUrl":null,"url":null,"abstract":"<p><p>Arthroscopic treatment of hip chondral lesions is a challenge. Recent research shows arthroscopic debridement with preservation of the subchondral bone plate shows superior results compared with microfracture. The results of microfracture can be unpredictable, largely because of the formation of fibrocartilage, which lacks the durability of hyaline cartilage. Autologous matrix-induced chondrogenesis has emerged as a promising alternative. This technique combines microfracture or abrasion with the application of a collagen membrane and aims to enhance the quality of the repair tissue. Autologous matrix-induced chondrogenesis not only improves patient-reported outcomes but also decreases the rate of conversion to total hip arthroplasty when compared with microfracture. Yet, the results remain only fair and variable. Autologous chondrocyte implantation, which involves the cultivation and reimplantation of chondrocytes, although more labor-intensive, may lead to a more robust and durable repair. In addition, newer methods like minced cartilage implantation show encouraging early results. We are in the early stages of understanding cartilage repair, and individual patient factors, such as size of the lesion, patient age, activity level, and coexisting conditions all require consideration.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Editorial Commentary: The Ideal Treatment Option for Hip Cartilage Repair Remains Elusive and Requires Consideration of Individual Patient Factors.\",\"authors\":\"Alexander Zimmerer\",\"doi\":\"10.1016/j.arthro.2024.09.044\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Arthroscopic treatment of hip chondral lesions is a challenge. Recent research shows arthroscopic debridement with preservation of the subchondral bone plate shows superior results compared with microfracture. The results of microfracture can be unpredictable, largely because of the formation of fibrocartilage, which lacks the durability of hyaline cartilage. Autologous matrix-induced chondrogenesis has emerged as a promising alternative. This technique combines microfracture or abrasion with the application of a collagen membrane and aims to enhance the quality of the repair tissue. Autologous matrix-induced chondrogenesis not only improves patient-reported outcomes but also decreases the rate of conversion to total hip arthroplasty when compared with microfracture. Yet, the results remain only fair and variable. Autologous chondrocyte implantation, which involves the cultivation and reimplantation of chondrocytes, although more labor-intensive, may lead to a more robust and durable repair. In addition, newer methods like minced cartilage implantation show encouraging early results. We are in the early stages of understanding cartilage repair, and individual patient factors, such as size of the lesion, patient age, activity level, and coexisting conditions all require consideration.</p>\",\"PeriodicalId\":55459,\"journal\":{\"name\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2024-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.arthro.2024.09.044\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2024.09.044","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Editorial Commentary: The Ideal Treatment Option for Hip Cartilage Repair Remains Elusive and Requires Consideration of Individual Patient Factors.
Arthroscopic treatment of hip chondral lesions is a challenge. Recent research shows arthroscopic debridement with preservation of the subchondral bone plate shows superior results compared with microfracture. The results of microfracture can be unpredictable, largely because of the formation of fibrocartilage, which lacks the durability of hyaline cartilage. Autologous matrix-induced chondrogenesis has emerged as a promising alternative. This technique combines microfracture or abrasion with the application of a collagen membrane and aims to enhance the quality of the repair tissue. Autologous matrix-induced chondrogenesis not only improves patient-reported outcomes but also decreases the rate of conversion to total hip arthroplasty when compared with microfracture. Yet, the results remain only fair and variable. Autologous chondrocyte implantation, which involves the cultivation and reimplantation of chondrocytes, although more labor-intensive, may lead to a more robust and durable repair. In addition, newer methods like minced cartilage implantation show encouraging early results. We are in the early stages of understanding cartilage repair, and individual patient factors, such as size of the lesion, patient age, activity level, and coexisting conditions all require consideration.
期刊介绍:
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.