Treatment of articular cartilage injuries to the knee remains a considerable challenge today. Current procedures succeed in providing relief of symptoms, however damaged articular tissue is not replaced with new tissu...Treatment of articular cartilage injuries to the knee remains a considerable challenge today. Current procedures succeed in providing relief of symptoms, however damaged articular tissue is not replaced with new tissue of the same biomechanical properties and long-term durability as normal hyaline cartilage. Despite many arthroscopic procedures that often manage to achieve these goals, results are far from perfect and there is no agreement on which of these procedures are appropriate, particularly when full-thickness chondral defects are considered.Therefore, the search for biological solution in long-term functional healing and increasing the quality of wounded cartilage has been continuing. For achieving this goal and apply in wide defects, scaffolds are developed.The rationale of using a scaffold is to create an environment with biodegradable polymers for the in vitro growth of living cells and their subsequent implantation into the lesion area. Previously a few numbers of surgical treatment algorithm was described in reports, however none of them contained one-step or two –steps scaffolds. The ultimate aim of this article was to review various arthroscopic treatment options for different stage lesions and develop a new treatment algorithm which included the scaffolds.展开更多
AIM: To explore the effect of platelet-rich plasma on protein expression patterns of transforming growth factor-beta1(TGF-β1) in cartilage following autologous osteochondral transplantation(AOT) in a rabbit knee cart...AIM: To explore the effect of platelet-rich plasma on protein expression patterns of transforming growth factor-beta1(TGF-β1) in cartilage following autologous osteochondral transplantation(AOT) in a rabbit knee cartilage defect model.METHODS: Twelve New Zealand white rabbits received bilateral AOT. In each rabbit, one knee was randomized to receive an autologous platelet rich plasma(PRP) injection and the contralateral knee received saline injection. Rabbits were euthanized at 3, 6 and 12 wk post-operatively. Articular cartilage sections were stained with TGF-β1 antibody. Histological regions of interest(ROI)(left, right and center of the autologous grafts interfaces) were evaluated using Meta Morph. Percentage of chondrocytes positive for TGF-β1 was then assessed.RESULTS: Percentage of chondrocytes positive for TGF-β1 was higher in PRP treated knees for selected ROIs(left; P = 0.03, center; P = 0.05) compared to control and was also higher in the PRP group at each post-operative time point(P = 6.6 × 10^(-4), 3.1 × 10^(-4) and 7.3 × 10^(-3) for 3, 6 and 12 wk, respectively). TGF-β1 expression was higher in chondrocytes of PRP-treated knees(36% ± 29% vs 15% ± 18%)(P = 1.8 × 10^(-6)) overall for each post-operative time point and ROI. CONCLUSION: Articular cartilage of rabbits treated with AOT and PRP exhibit increased TGF-β1 expression compared to those treated with AOT and saline. Our findings suggest that adjunctive PRP may increase TGF-β1 expression, which may play a role in the chondrogenic effect of PRP in vivo.展开更多
[目的]比较自体骨软骨移植术(osteochondral autologous transplantation,0AT)与镜下微骨折术(microfracture,MF)治疗Hepple Ⅲ〜Ⅳ型距骨骨软骨损伤(osteochondral lesion of the talus,0LT)的临床效果。[方法]回顾性分析2015年5月-2019...[目的]比较自体骨软骨移植术(osteochondral autologous transplantation,0AT)与镜下微骨折术(microfracture,MF)治疗Hepple Ⅲ〜Ⅳ型距骨骨软骨损伤(osteochondral lesion of the talus,0LT)的临床效果。[方法]回顾性分析2015年5月-2019年5月本院收治的HeppleDNIV型0LT患者96例,其中,50例采用0AT治疗,46例采用MF治疗。比较两组围手术期、随访和影像学资料。[结果]0AT组的围手术期指标均明显差于MF组(P<0.05)。末次随访时,0AT组在VAS、A0FAS评分和ROM方面均显著优于MF组(P<0.05)。末次随访时,0AT组Outerbridge评级和Kellgren-Lawrence分级均显著优于MF组(P<0.05)[结论]0AT和MF均可有效治疗0LT,相比之下,0AT虽手术创伤大,但短期随访效果优于MF。展开更多
文摘Treatment of articular cartilage injuries to the knee remains a considerable challenge today. Current procedures succeed in providing relief of symptoms, however damaged articular tissue is not replaced with new tissue of the same biomechanical properties and long-term durability as normal hyaline cartilage. Despite many arthroscopic procedures that often manage to achieve these goals, results are far from perfect and there is no agreement on which of these procedures are appropriate, particularly when full-thickness chondral defects are considered.Therefore, the search for biological solution in long-term functional healing and increasing the quality of wounded cartilage has been continuing. For achieving this goal and apply in wide defects, scaffolds are developed.The rationale of using a scaffold is to create an environment with biodegradable polymers for the in vitro growth of living cells and their subsequent implantation into the lesion area. Previously a few numbers of surgical treatment algorithm was described in reports, however none of them contained one-step or two –steps scaffolds. The ultimate aim of this article was to review various arthroscopic treatment options for different stage lesions and develop a new treatment algorithm which included the scaffolds.
基金Supported by Arteriocyte Inc.the Ohnell Family Foundationand Mr.and Mrs.Michael J Levitt
文摘AIM: To explore the effect of platelet-rich plasma on protein expression patterns of transforming growth factor-beta1(TGF-β1) in cartilage following autologous osteochondral transplantation(AOT) in a rabbit knee cartilage defect model.METHODS: Twelve New Zealand white rabbits received bilateral AOT. In each rabbit, one knee was randomized to receive an autologous platelet rich plasma(PRP) injection and the contralateral knee received saline injection. Rabbits were euthanized at 3, 6 and 12 wk post-operatively. Articular cartilage sections were stained with TGF-β1 antibody. Histological regions of interest(ROI)(left, right and center of the autologous grafts interfaces) were evaluated using Meta Morph. Percentage of chondrocytes positive for TGF-β1 was then assessed.RESULTS: Percentage of chondrocytes positive for TGF-β1 was higher in PRP treated knees for selected ROIs(left; P = 0.03, center; P = 0.05) compared to control and was also higher in the PRP group at each post-operative time point(P = 6.6 × 10^(-4), 3.1 × 10^(-4) and 7.3 × 10^(-3) for 3, 6 and 12 wk, respectively). TGF-β1 expression was higher in chondrocytes of PRP-treated knees(36% ± 29% vs 15% ± 18%)(P = 1.8 × 10^(-6)) overall for each post-operative time point and ROI. CONCLUSION: Articular cartilage of rabbits treated with AOT and PRP exhibit increased TGF-β1 expression compared to those treated with AOT and saline. Our findings suggest that adjunctive PRP may increase TGF-β1 expression, which may play a role in the chondrogenic effect of PRP in vivo.
文摘[目的]比较自体骨软骨移植术(osteochondral autologous transplantation,0AT)与镜下微骨折术(microfracture,MF)治疗Hepple Ⅲ〜Ⅳ型距骨骨软骨损伤(osteochondral lesion of the talus,0LT)的临床效果。[方法]回顾性分析2015年5月-2019年5月本院收治的HeppleDNIV型0LT患者96例,其中,50例采用0AT治疗,46例采用MF治疗。比较两组围手术期、随访和影像学资料。[结果]0AT组的围手术期指标均明显差于MF组(P<0.05)。末次随访时,0AT组在VAS、A0FAS评分和ROM方面均显著优于MF组(P<0.05)。末次随访时,0AT组Outerbridge评级和Kellgren-Lawrence分级均显著优于MF组(P<0.05)[结论]0AT和MF均可有效治疗0LT,相比之下,0AT虽手术创伤大,但短期随访效果优于MF。
