骨髓浓缩物增强无细胞文石支架修复膝关节骨软骨缺损。

Video journal of sports medicine Pub Date : 2025-06-26 eCollection Date: 2025-05-01 DOI:10.1177/26350254241303767
Ron Gilat, Alexander C Weissman, Andrew R Phillips, Allen A Yazdi, Sarah A Muth, Brian J Cole
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引用次数: 0

摘要

背景:关节表面损伤,影响关节软骨和其下的软骨下骨,是严重膝关节疼痛和功能障碍的常见原因。CartiHeal Agili-C是一种无细胞文石为基础的植入物,对于那些不适合同种异体移植或供体组织有限的地理区域的患者来说,使用这种植入物是一种新兴的选择。适应症:CartiHeal Agili-C种植体适用于国际软骨修复协会III级或IV级病变,总可治疗面积为1至7cm2,无严重骨关节炎的患者。技术描述:标准髌旁关节切开术显示股骨髁骨软骨缺损。然后根据Agili-C工具集中的编号仪器分7步移植无细胞文石支架。手术的定位要点包括垂直对准器工具的正确对准和周向观察、辅助确认和关节镜验证;在成形阶段避免摇晃,因为这可能导致固定不充分的椭圆形窝;小心地操作植入物,只用拇指或食指轻轻拍打插入。结果:一项多中心随机对照试验随访了251例患者,发现88.5%的种植体组在术后2年随访的磁共振成像中至少有75%的病变填充。此外,与对照组相比,患者报告的结果测量在24个月时具有统计学优势。结论:无细胞文石支架(Aglili-C;CartiHeal有限公司(CartiHeal Ltd),辅以浓缩骨髓抽吸液,为股骨髁骨软骨缺损的治疗提供了一种高效、可重复的手术策略。患者同意披露声明:作者证明已获得本出版物中出现的任何患者的同意。如果患者的身份是可识别的,作者必须在提交的文件中附上患者的免责声明或其他书面批准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cell-Free Aragonite-Based Scaffold With Bone Marrow Aspirate Concentrate Augmentation for Osteochondral Defects of the Knee.

Background: Damage to the joint surface, which affects articular cartilage and the underlying subchondral bone, is a common cause for significant knee pain and disfunction. The use of CartiHeal Agili-C, a cell-free aragonite-based implant, is an emerging option for patients who may otherwise be a poor candidate for allograft transplantation or within geographic areas where there is a limited availability of donor tissue.

Indications: The CartiHeal Agili-C implant is indicated for patients with an International Cartilage Repair Society grade III or IV lesion with a total treatable area of 1 to 7 cm2 and without severe osteoarthritis.

Technique description: Standard parapatellar arthrotomy is performed to reveal an osteochondral defect of the femoral condyle. The cell-free aragonite-based scaffold is then transplanted in 7 steps according to numbered instrumentation in the Agili-C toolset. Surgical pearls of placement include proper alignment of the perpendicular aligner tool with circumferential viewing, assistant confirmation, and arthroscopic verification; avoiding wobbling during the shaping phase of the procedure as this may cause an oblong socket with inadequate fixation; and handling the implant with care and only using a thumb or index finger to insert with light tapping.

Results: A multicenter randomized control trial followed 251 patients and found 88.5% of the implant group had at least 75% lesion fill as seen on postoperative magnetic resonance imaging at a 2-year follow-up. Additionally, patient-reported outcome measures were statistically superior when compared to controls at 24 months.

Conclusion: Transplantation of a cell-free aragonite-based scaffold (Aglili-C; CartiHeal Ltd), augmented with bone marrow aspirate concentrate, provides an efficient, reproducible surgical strategy in the management of osteochondral defects of the femoral condyles.

Patient consent disclosure statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

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