摘要
背景:随着医疗水平的提高和人们对生活质量的更高要求,临床对软骨修复的质量和要求也越来越高,传统修复方法不能再生具有良好生物性能的软骨。目的:综述近年来自体软骨细胞移植的相关研究进展,分析其发展历程、基础科学、适应证、禁忌证、外科技术、临床疗效和局限性,展望该领域的发展趋势。方法:以"软骨细胞移植、骨缺损、临床技术、临床疗效、适应证、禁忌证、缺损大小、翻修、恢复运动、年龄、影像学、局限性""autologous chondrocyte implantation,cartilage defect,techniques,clinical effect,indications,contraindications,defect size,treatment after initial failure,return to sports,age,magnetic resonance imaging,limitation"等作为关键词,在CNKI、PubMed、Web of Science、Google scholar数据库进行检索,文献类型包括:研究原著、综述、病例报告、荟萃分析等,检索时间限定为1990至2020年,共检索到文献1 000余篇,最终纳入52篇进行综述。结果与结论:自体软骨细胞移植在1980年代晚期首次出现,用于治疗膝关节软骨缺损。第1代自体软骨细胞移植使用骨膜贴片将培养的软骨细胞封闭在缺损中,由于骨膜移植体增生的问题,开发了利用胶原膜贴片的第2代自体软骨细胞移植;第3代自体软骨细胞移植应用三维培养技术有利于细胞迁移,允许微创性植入,更好地再生正常的软骨结构,加速康复。自体软骨细胞移植是治疗胫骨或股骨软骨缺损的有效方法,但是必须先解决冠状位力线不齐、韧带松弛、半月板损伤等问题。由于移植物成熟所需的时间较长,因此必须特别考虑运动恢复方案,这可以协助损伤者在移植物充分成熟之前尽可能恢复力量和神经肌肉的协调效应。
BACKGROUND:With the improvement of the medical level and people’s higher requirements for the quality of life,the quality and requirements for cartilage repair in the clinic are getting more and more,but traditional repair methods cannot regenerate cartilage with good biological properties.OBJECTIVE:To review the research progress of autologous chondrocyte implantation in recent years,and to analyze its development process,basic science,indications,contraindications,surgical techniques,clinical efficacy and limitations,and look forward to the development trend of this field.METHODS:A computer-based online search of CNKI,PubMed,Web of Science databases,and Google Scholar was performed to retrieve papers published during 1990-2020 with the search terms“autologous chondrocyte implantation,cartilage defect,techniques,clinical effect,indications,contraindications,defect size,treatment after initial failure,return to sports,age,magnetic resonance imaging,limitation”in English and Chinese.The document types include treatise,reviews,case reports,and meta-analysis.A total of over 1000 papers were retrieved,and 52 of them were included in the final analysis.RESULTS AND CONCLUSION:Autologous chondrocyte transplantation first appeared for the treatment of knee cartilage defects in the late 1980s.The first generation of autologous chondrocyte transplantation used periosteal patches to seal the cultured chondrocytes in the defect.Due to the proliferation of periosteal grafts,second-generation autologous chondrocyte transplantation used collagen membrane patches instead of periosteal patches.The third generation of autologous chondrocyte transplantation used three-dimensional culture technology to improve cell delivery,allowing minimally invasive implantation,which could regenerate normal cartilage structure with accelerating patient recovery.Autologous chondrocyte transplantation was an effective method to treat high tibia or femoral cartilage defects,but it must solve the problems consisting of coronal force line,ligame
作者
李想
符培亮
Li Xiang;Fu Peiliang(Department of Joint Surgery,Changzheng Hospital of Naval Medical University,Shanghai 200003,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第25期4076-4081,共6页
Chinese Journal of Tissue Engineering Research
基金
上海市科学技术委员会科研项目(17411971800),项目负责人:符培亮。
关键词
软骨细胞
软骨缺损
基础科学
临床技术
适应证
禁忌证
疗效
移植
综述
chondrocyte
cartilage defect
basic science
clinical technology
indication
contraindication
curative effect
transplantation
review
