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Biologic Augm.nted m.crodrilling Surgery for m.ltiple and Large Full-Thickness Cartilage Lesions in the Knee: Early Clinical and Radiological Results

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Surgical Science 2017年第2期8卷 102-117页

作者： Joseph E. Broyles m. adaire o’brien Stephanie T. Broyles m. Patrick Stagg Bone and Joint Clinic of Baton Rouge Baton Rouge Louisiana USA Pennington Biom.dical Research Center Baton Rouge Louisiana USA m.dical oncology oLoL Physician Group Baton Rouge Louisiana USA

Background: Various biologic treatm.nts are available for articular cartilage lesions in the knee, but no one exists that is applicable to the full range of chondral disease and that is com.liant with United States Food and Drug Adm.nistration regulations. The aim.of this study was to evaluate outcom.s following m.crodrilling surgery augm.nted with postoperative injections of bone m.rrow aspirate concentrate (Bm.C), platelet rich plasm. (PRP) and hyaluronic acid (HA). m.thods: Eighteen patients with at least one sym.tom.tic, full-thickness chondral lesion underwent arthroscopic m.crodrilling surgery. Im.ediately following surgery, patients received an intra-articular injection of fresh Bm.C, PRP, and HA. This injection was repeated once per week for 5 consecutive weeks. At 4 and 12 m.nths postoperatively, patients received 3 additional weekly injections for a total of 12 injections. outcom. m.asures: IKDC (International Knee Docum.ntation Com.ittee) scores, KS (Knee Society) scores and plain radiographs. Results: The m.an treated area was 6.2 ± 4.5 (range, 0.6 - 14.7) cm.. The m.an preoperative IKDC and KS scores (±SE) were 43.0 ± 3.2 and 68.3 ± 3.6 respectively. At 24 m.nths postoperatively, IKDC and KS scores im.roved to 85.3 ± 4.2 and 94.7 ± 4.4, respectively;both changes from.baseline were significant (p p = 0.05). This change was greater in patients with preoperative JS p for the difference between groups = 0.1). Conclusions: m.crodrilling of cartilage lesions augm.nted with Bm.C, PRP, and HA m.y be a viable treatm.nt for a range of chondral disease with good early clinical and radiological results.

关键词： Cartilage m.crodrilling Stem Cells Joint Space

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