RESUMO
BACKGROUND: Osteochondral lesion of the talus is a common disease of foot and ankle surgery, which has the characteristics of high morbidity, high misdiagnosis rate and difficulty in curing. OBJECTIVE: To summarize the etiology, clinical manifestations, diagnostic methods, clinical grading, treatment methods, and new therapies such as cell therapy and tissue engineering for osteochondral lesion of the talus.METHODS: The first author retrieved PubMed databases for relevant articles. The keywords were "talus, cartilage". Initially, 535 articles were retrieved, and finally 70 articles were included in result analysis. RESULTS AND CONCLUSION: Trauma is still considered to be the main pathogenic factor of talus cartilage injury. According to the imaging findings, the clinical scope of talar cartilage injury can be accurately determined. The clinically applied therapies have certain shortcomings and limitations. Tissue engineering-based therapies are currently the most likely to cure osteochondral lesion of the talus.
RESUMO
BACKGROUND:Stem cel is a kind of pluripotent cels with self-replication ability, which can differentiate into various cels under certain conditions. Furthermore, stem cels are rich in a variety of growth factors, which can induce the generation of vessels and nerves, and improve the blood supply of lower limbs, thereby achieving the treatment and preventions of lower limb ischemia OBJECTIVE:To summarize and compare the recent achievements in the theory and therapeutic efficacy of stem cels from different sources in the treatment of diabetic foot. METHODS:The first and second authors retrieved PubMed, Sciencedirect and Medline databases for relevant articles published from January 2000 to January 2015. The key words were “diabetic foot, pathogenesis, stem cel therapy” in English. Initialy, 186 articles were retrieved, and finaly 44 articles were included in result analysis. RESULTS AND CONCLUSION:Stem cels can be a new choice for the treatment of diabetic foot. After stem cel therapy, corresponding symptoms have been aleviated, including the generation of new blood vessels and the reshaping of the colateral vessels, the improvement of motor nerve conduction velocity and nerve reflex, the improvement of the sense of skin pain and temperature, and pain relief. It is stil unclear whether alogeneic stem cels are safe or not, but autologous stem cels, especialy bone marrow mesenchymal stem cels, can be better able to repair damaged vessels and nerves and restore the microcirculation of blood supply. Currently, we need to do more basic and clinical researches to solve the folowing problems: to confirm the effectiveness and safety of stem cel therapy for diabetic foot; to identify whether there is a difference in the differentiation and secretory activity between stem cels in diabetic patients and ordinary people; to give ful play to the treatment of diabetic foot.