一种新型3d胶原凝胶(CaReS)治疗膝关节局灶性软骨缺损的首次临床经验。

S Andereya, U Maus, K Gavenis, R Müller-Rath, O Miltner, T Mumme, U Schneider
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引用次数: 66

摘要

目的:在这项前瞻性研究中,我们提出了一种基于基质的软骨细胞移植治疗局灶性软骨缺损的新技术。方法:采用自体软骨细胞植入的3d - i型胶原凝胶(CaReS)治疗22例股骨软骨或骨软骨缺损。本文描述了这种新方法的总体处理方法,并介绍了2年后关于icrs评分的随访结果。结果:14例患者因局灶性软骨病变而接受治疗,8例软骨下骨重建。平均缺陷尺寸为6 cm(2)。在所有情况下,细胞种子基质样品都可以用纤维蛋白胶固定,没有任何问题。平均手术时间69 min,手术入路长度8.2 cm。没有观察到手术特有的问题。随访3、6个月至2年后,患者的ikdc评分、功能评分和总体评分均有显著改善。术后2年后,对13例患者进行评估,84.6%的患者认为基于基质的缺损治疗良好至优秀。结论:细胞种子3d胶原凝胶治疗骨缺损易处理,随访2年临床效果良好。进一步的研究需要更多的患者数量,更长的随访时间和组织学和生物力学样本分析,以建立该方法作为传统ACT的改进。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[First clinical experiences with a novel 3D-collagen gel (CaReS) for the treatment of focal cartilage defects in the knee].

Aim: In this prospective study we present a novel technique of matrix-based chondrocyte transplantation for the treatment of focal cartilage defects.

Method: 22 patients with chondral or osteochondral femoral defects were treated with 3D-collagen type-I gel seeded with autologous chondrocytes (CaReS). Overall handling of this novel method is described, and results after 2 years follow-up with regard to the ICRS-score are presented.

Results: 14 patients were treated because of a focal chondral lesion, in 8 cases subchondral bone had to be reestablished. The average defect size was 6 cm(2). In all cases cell-seeded matrix samples could be fixed with fibrin glue without any problems. The average surgery time was 69 min, length of the surgical approach was 8.2 cm. No surgery-specific problems had to be observed. A significant improvement in IKDC-score, functional score and overall rating after 3 or 6 months up to 2 years follow-up was detected. After 2 years post-OP 13 Patients were evaluated and matrix-based defect treatment by CaReS was rated good to excellent by 84.6 % of the patients.

Conclusion: Defect treatment with cell-seeded 3D-collagen gel is easy to handle with a good clinical outcome after 2 years follow-up. Further investigations with higher patient number, longer follow-up time and histological and biomechanical sample analysis are needed in order to establish this method as an improvement of conventional ACT.

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