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。

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Alexander Zimmerer
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引用次数: 0

摘要

髋关节软骨损伤的关节镜治疗是一项挑战。最新研究表明,关节镜下清创并保留软骨下骨板的效果优于微骨折。微骨折的效果可能难以预测,这主要是由于纤维软骨的形成缺乏透明软骨的耐久性。自体基质诱导软骨生成(AMIC)已成为一种很有前途的替代方法。这项技术结合了微骨折或磨削术以及胶原蛋白膜的应用,旨在提高修复组织的质量。与微骨折相比,AMIC 不仅能改善患者报告的结果,还能降低转为 THA 的比例。然而,其结果仍然只是一般和可变的。自体软骨细胞植入术(ACI)涉及软骨细胞的培养和再植入,虽然更耗费人力,但可能带来更稳固、更持久的修复效果。此外,碎软骨植入等新方法也显示出令人鼓舞的早期效果。我们对软骨修复的认识还处于早期阶段,患者的个体因素,如病变大小、年龄、活动水平和并存病症等都需要考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
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.
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