Microfracture technique and osteochondral transplantation in the treatment of articular cartilage defects / 中国组织工程研究

ABSTRACT

BACKGROUND:Microfracture technique and osteochondral transplantation are one of the methods for the treatment of articular cartilage defects with broad application prospects. OBJECTIVE:To investigate the effect of microfracture technique and autologous and al ogeneic osteochondral transplantation in the treatment of knee osteoarthritis complicated with articular cartilage defects. METHODS:The articular cartilage defects were treated with arthroscopic debridement combined with microfracture surgery in the cartilage defect region, and then the clinical effect, clinical symptoms and Tenger sport score were detected. The patients were fol owed-up for 3-24 months. The articular cartilage defects patients treated with autologous osteochondral transplantation were fol owed-up. The effect of autologous osteochondral transplantation was evaluated through assessing the range of motion after transplantation, improvement of clinical symptoms and joint imaging examination. The animal experiment of al ogeneic osteochondral transplantation for the treatment of articular cartilage defects was conducted to evaluate the effect of al ogeneic osteochondral transplantation through general observation of transplantation site, histological and immunohistochemical staining. RESULTS AND CONCLUSION:For the patients treated with arthroscopic microfracture technique, the total efficiency of joint debridement combined with microfracture surgery in the cartilage defect region was 89.7%. For the articular cartilage defects patients treated with autologous osteochondral transplantation, the symptoms of joint pain and swel ing were improved, and the range of motion was normal with rest pain and slight pain after movement occasional y. Radiographic examination showed the transplanted osteochondral was in good position with good healing. In the experiment animals with articular cartilage defects after treated with al ogeneic osteochondral transplantation, the range of motion was normal, transplanted articular surface was finishing, the articular cartilage was covered with hyaline cartilage, and the cells were arranged in order;there was cartilage matrix secretion, and the col agen type II in the repaired articular cartilage was strongly positive with immunohistochemical staining.