https://scholars.lib.ntu.edu.tw/handle/123456789/507514
標題: | Clinical feasibility of a novel biphasic osteochondral composite for matrix-associated autologous chondrocyte implantation | 作者: | HONGSEN CHIANG Liao C.-J. Hsieh C.-H. CHIEH-YU SHEN YI-YOU HUANG Jiang C.-C. |
公開日期: | 四月-2013 | 卷: | 21 | 期: | 4 | 起(迄)頁: | 589 | 來源出版物: | Osteoarthritis and Cartilage | 摘要: | Objective: Matrix-associated autologous chondrocyte implantation has been used to treat cartilage defects. We developed a biphasic cylindrical osteochondral composite construct for such use, and conducted this study to determine its feasibility for treating osteochondral lesions in human knees. Method: Ten patients with symptomatic osteochondral lesions at femoral condyles were treated by replacing pathological tissue with the construct of dl-poly-lactide-co-glycolide, whose lower body was impregnated with β-tricalcium phosphate and served as osseous phase. The construct had a chamber to load double-minced autologous cartilage, serving as source of chondrocytes. Osteochondral lesion was drill-fashioned a pit of identical dimension as the construct. Chondrocyte-laden construct was press-fit to fill the pit. Postoperative outcome was evaluated using Knee Injury and Osteoarthritis Outcome Score (KOOS) scale up to 24 months. Magnetic resonance image was taken, and sample tissue was collected with second-look arthroscopic needle biopsy at 12 months. Outcome parameters were primarily safety of surgery, and secondarily postoperative change in KOOS and regeneration of hyaline cartilage and cancellous bone. Results: No patient experienced serious adverse events. Postoperative mean KOOS in "symptoms" subscale had not changed significantly from pre-operation until 24 months; whereas those in the other four subscales were significantly higher than pre-operation at 12 and 24 months. Second-look arthroscopy showed completely filled grafted sites, with regenerate cartilaginous surfaces flushed with surrounding native joint surface. Microscopically, regenerated cartilage appeared hyaline. Conclusion: This novel construct for chondrocyte implantation is safe for surgical application in knee. It repairs osteochondral lesions of femoral condyles by successful regeneration of hyaline cartilage. ? 2013 Osteoarthritis Research Society International. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84874966784&doi=10.1016%2fj.joca.2013.01.004&partnerID=40&md5=fedfc7a753abc5730b8c222f7bd22947 https://scholars.lib.ntu.edu.tw/handle/123456789/507514 http://ntur.lib.ntu.edu.tw//handle/246246/260197 |
ISBN: | 1063-4584 | DOI: | 10.1016/j.joca.2013.01.004 | SDG/關鍵字: | biphasic cylindrical osteochondral composite; calcium phosphate; chondrocyte implant; polyglactin; unclassified drug; adult; article; cartilage; cartilage cell; chondrocyte implantation; chondropathy; clinical article; composite material; controlled study; female; femur condyle; human; human tissue; hyaline cartilage; knee arthroscopy; Knee Injury and Osteoarthritis Outcome Score; knee osteochondral lesion; male; matrix associated autologous chondrocyte implantation; needle biopsy; nuclear magnetic resonance imaging; outcome assessment; postoperative period; preoperative evaluation; priority journal; trabecular bone; Adult; Arthroscopy; Bone Regeneration; Cartilage, Articular; Chondrocytes; Feasibility Studies; Female; Humans; Knee Injuries; Knee Joint; Lactic Acid; Magnetic Resonance Imaging; Male; Middle Aged; Osteochondritis Dissecans; Polyglycolic Acid; Postoperative Complications; Regeneration; Severity of Illness Index; Tissue Engineering; Tissue Scaffolds; Treatment Outcome; Young Adult |
顯示於: | 醫學系 |
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