李刚;焦强;王春理;赵瑞鹏;石一璠;李鹏翠;卫小春;

• 1:山西医科大学第二医院骨科骨与软组织损伤与修复山西省重点实验室

摘要(Abstract)：

软骨损伤后自体修复能力差,往往需要通过外科手段进行修复。但是传统的外科方法如关节灌洗术和清理术、骨髓刺激术、骨软骨自体/同种异体移植术等效果不是很理想。目前为止,自体软骨细胞移植术(ACI)是修复软骨缺损的有效方法。随着组织工程技术在软骨缺损修复方面的发展,ACI发展、创新至第三代技术:基质诱导自体软骨细胞移植术(MACI)。随后根据支架材料的不同MACI又出现一些改良技术,各有特点和优势,本文就MACI及其改良技术的发展作一综述。

关键词(KeyWords)： 软骨损伤;ACI;支架;组织工程

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金面上项目(编号:81572098);国家自然科学基金(编号:8160949);; 山西省回国留学人员科研资助项目(编号:2016-118)

作者(Author): 李刚;焦强;王春理;赵瑞鹏;石一璠;李鹏翠;卫小春;

Email:

DOI:

参考文献(References)：

• [1]卫小春.关节软骨[M].北京:科学出版社,2007:56.
• [2]Negrin L,Kutscha-Lissberg F,Gartlehner G,et al.Clinical outcome after microfracture of the knee:a meta-analysis of before/after-data of controlled studies[J].Int Orthop,2012,36(1):43-50.
• [3]Demange M,Gomoll AH.The use of osteochondral allografts in the management of cartilage defects[J].Curr Rev Musculoskelet Med,2012,5(3):229-235.
• [4]Brittberg M,Lindahl A,Nilsson A,et al.Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation[J].N Engl J Med,1994,331(14):889-895.
• [5]Gooding CR,Bartlett W,Bentley G,et al.A prospective,randomised study comparing two techniques of autologous chondrocyte implantation for osteochondral defects in the knee:periosteum covered versus type I/III collagen coveredv J].Knee,2006,13(3):203-210.
• [6]Kon E,Delcogliano M,Filardo G,et al.Second generation issues in cartilage repairv[J].Sports Med Arthrosc,2008,16:221-229.
• [7]Behrens P,Ehlers EM,Kochermann KU,et a1.New therapy procedure for localized cartilage defects.Encouraging results with autologous chondrocyte implantationv[J].MMW Fortschr Med,l999,14l(45):49-51.
• [8]Basad E,Ishaque B,Bachmann Get,et al.Matrix-induced autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee:a 2-year randomised study[J].Knee Surg Sports Traumatol Arthrosc,2010,18(4):519-527.
• [9]Basad E,Wissing FR,Fehrenbach P,et al.Matrix-induced autologous chondrocyte implantation(MACI)in the knee:clinical outcomes and challenges[J].Knee Surg Sports Traumatol Arthrosc,2015,23(12):3729-3735.
• [10]Zhang Z,Zhong X,Ji H,et al.Matrix-induced autologous chondrocyte implantation for the treatment of chondral defects of the knees in Chinese patients[J].Drug Des Devel Ther,2014,8:2439-2448.
• [11]Gille J,Behrens P,Schulz AP,et al.Matrix-associated autologous chondrocyte implantation:a clinical follow-up at 15 years[J].Cartilage,2016,7(4):309-3015.
• [12]Nehrer S,Chiari C,Domayer S,et al.Results of chondrocyte implantation with a fibrin-hyaluronan matrix:a preliminary study[J].Clin Orthop,2008,466(8):1849-1855.
• [13]Domayer SE,Welsch GH,Nehrer S,et al.T2 mapping and d GEMRIC after autologous,chondrocyte implantation with a fibrin-based scaffold in,the knee:preliminary results[J].Eur J Radiol,2009,73(3):636-642.
• [14]Eshed I,Trattnig S,Sharon M,et al.Assessment of cartilage repair after chondrocyte transplantation with a fibrin-hyaluronan matrix:correlation of morphological MRI,biochemical T2 mapping and clinical outcome[J].Eur J Radiol,2012,81(6):1216-1223.
• [15]Marcacci M,Berruto M,Brocchetta D,et al.Articular cartilage engineering,with Hyalograft C:3-year clinical results[J].Clin Orthop,2005,435(435):96-105.
• [16]Grigolo B,Lisignoli G,Piacentini A,et al.Evidence for redifferentiation of human chondrocytes grown on a hyaluronan-based biomaterial(HYAff 11):molecular,immunohistochemical and ultrastructural analysis[J].Biomaterials,2002,23(4):1187-1195.
• [17]Brix MO,Stelzeneder D,Trattnig S,et al.Cartilage repair of the knee with Hyalograft C:magnetic resonance imaging assessment of the glycosaminoglycan content at midterm[J].Int Orthop,2013,37(1):39-43.
• [18]Kon E,Filardo G,Berruto M,et al.Articular cartilage treatment in high-level male soccer players:a prospective comparative study of arthroscopic second-generation autologous chondrocyte implantation versus microfracture[J].Am J Sports Med,2011,39(12):2549-2557.
• [19]Brix MO,Stelzeneder D,Chiari C,et al.Treatment of full-thickness chondral defects with hyalograft c in the knee:long-term results[J].Am J Sports Med,2014,42(6):1426-1432.
• [20]Madeira C,Santhagunam A,Salgueiro JB,et al.Advanced cell therapies for articular cartilage regeneration[J].Trends Biotechnol,2015,33(1):35-42.
• [21]Kon E,Filardo G,Di Matteo B,et al.Matrix assisted autologous chondrocyte transplantation for cartilage treatment[J].Bone JointRes,2013,2(2):18-25.
• [22]Erggelet C,Kreuz PC,Mrosek EH,et al.Autologous chondrocyte implantation versus ACI using 3D-bioresorbable graft for the treatment of large full-thickness cartilage lesions of the knee[J].Arch Orthop Trauma Surg,2010,130(8):957-964.
• [23]Kreuz PC,Müller S,Freymann U,et al.Repair of focal cartilage defects with scaffold-assisted autologous chondrocyte grafts:clinical and biomechanical results 48 months after transplantation[J].Am J Sports Med,2011,39(8):1697-1705.
• [24]Crawford DC,Heveran CM,Cannon WD Jr,et al.An autologous cartilage tissue implant Neo Cart for treatment of grade III chondral injury to the distal femur:prospective clinical safety trial at 2 years[J].Am J Sports Med,2009,37(7):1334-1343.
• [25]Crawford DC,De Berardino TM,Williams RJ.Neo Cart,an autologous cartilage tissue implant,compared with microfracture for treatment of distal femoral cartilage lesions:an FDA phase-II prospective,randomized clinical trial after two years[J].J Bone Joint Surg Am,2012,94(11):979-989.
• [26]Niethammer TR,Pietschmann MF,Ficklscherer A,et al.Incomplete defect filling after third generation autologous chondrocyte implantation[J].Arch Med Sci,2016,12(4):785-792.
• [27]Niethammer TR,Safi E,Ficklscherer A,et al.Graft maturation of autologous chondrocyte implantation:magnetic resonance investigation with T2 mapping[J].Am J Sports Med,2014,42(9):2199-2204.
• [28]Zak L,Albrecht C,Wondrasch B,et al.Results 2 years after matrix-associated autologous chondrocyte transplantation using the novocart 3D scaffold:an analysis of clinical and radiological data[J].Am J Sports Med,2014,42(7):1618-1627.
• [29]Schneider U,Rackwitz L,Andereya S,et al.A prospective multicenter study on the outcome of type I collagenhydrogel-based autologous chondrocyte implantation(Ca Re S)for the repair of articular cartilage defects in the knee[J].Am J Sports Med,2011,39(12):2558-2565.
• [30]Rackwitz L,Schneider U,Andereya S,et al.Reconstruction of osteochondral defects with a collagen I hydrogel.Results of a prospective multicenter study[J].Orthopedics,2012,41(4):268-279.
• [31]Selmi TA,Verdonk P,Chambat P,et al.Autologous chondrocyte implantation in a novel alginate-agarose hydrogel:outcome at two years[J].J Bone Joint Surg Br,2008,90(5):597-604.
• [32]Choi NY,Kim BW,Yeo WJ,et al.Gel-type autologous chondrocyte(Chondron)implantation for treatment of articular cartilage defects of the knee[J].BMC Musculoskelet Disord,2010,11(1):103.
• [33]Kim MK,Choi SW,Kim SR,et al.Autologous chondrocyte implantation in the knee using fibrin[J].Knee Surg Sports Traumatol Arthrosc,2010,18(4):528-534.
• [34]Takazawa K,Adachi N,Deie A,et al.Evaluation of magnetic resonance imaging and clinical outcome after tissue-engineered cartilage implantation:prospective 6-year follow-up study[J].J Orthop Sci,2012,17(4):413-424.
• [35]Tadenuma T,Uchio Y,Kumahashi N,et al.Delayed gadoliniumenhanced MRI of cartilage and T2 mapping for evaluation of reparative cartilage-like tissue after autologous chondrocyte implantation associated with Atelocollagen-based scaffold in the kneev[J].Skeletal Radiol,2016,45(10):1357-1363.
• [36]Tohyama H,Yasuda K,Minami A,et al.Atelocollagen-associated autologous chondrocyte implantation for the repair of chondral defects of the knee:a prospective multicenter clinical trial in Japan[J].J Orthop Sci,2009,14(5):579-588.