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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >A Prospective Outcome, MRI and Biospy Study of MACI Cartilage Transplantation
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A Prospective Outcome, MRI and Biospy Study of MACI Cartilage Transplantation

机译：MACI软骨移植的前瞻性结果，MRI和活检研究

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Objectives: MACI has been performed by one surgeon. in New Zealand in patients who have failed a microfracture procedure A prospective study with outcome scores, serial MRI’s and biopsies has been performed Method: Fifteen patients have had a MACI since July 2004. All patients have a five year follow up, four a ten year follow up. No patients have been lost to follow up. The mean age is 34 (range 25-45). The mean defect size is 3.76 cm~(2)(range 2.2 – 6.0 cm~(2)). VAS pain, KOOS score, IKDC subjective score, WOMAC score, SF 36 & Tegner Activity score were collected by a research assistant preoperatively and at 6 months, 1, 2, 3 5 and 10 years. An MRI scan was performed at all time intervals. Biopsies were taken at 3 – 5 years in all patients. Results: All outcome scores and VAS pain scores show a significant improvement post MACI up to two years, a plateau to five years the deteroriation at ten years. There are two failure to date thus survival is 87% at a mean of 8 years. MRI showed restoration of repair tissue with a mean fill of 90% at 2years, 72% at 5 years and 49% at ten years and all patients at ten years had a full thickness defect 86% of patients had bone oedema at 5 years, 100% at 10 years 28% had bone cysts at 5 years, 100% at 10 years All patients have had MACI biopsies. Eleven biopsies show fibrocartilage and four show hyaline like cartilage. Eleven have a normal ICRS arthroscopic score, three a nearly normal score and one abnormal score however 80% have a softer MACI graft than surrounding articular cartilage. Conclusion: Outcome scores are reasonable but are deterioating at 10 years Serial MRI’s show significant graft deterioration, increasing bone oedema and bone cyst formation At rearthroscopy 80% of grafts are soft and 73% of biopsies show fibrocartilage. MACI post microfracture is not the long term solution for isolated chondral defects.
机译：目标：MACI由一名外科医生进行。在新西兰，对微骨折手术失败的患者进行了前瞻性研究，包括结局评分，连续MRI和活组织检查方法：自2004年7月以来，有15位患者进行了MACI。所有患者均进行了5年的随访，每4年10年跟进。没有患者失访。平均年龄为34岁（范围为25-45）。平均缺陷尺寸为3.76 cm〜（2）（范围2.2 – 6.0 cm〜（2））。术前和术后6个月，1、2、3、5和10年，由研究助理收集VAS疼痛，KOOS评分，IKDC主观评分，WOMAC评分，SF 36和Tegner活动评分。在所有时间间隔均进行MRI扫描。所有患者均于3-5年进行活检。结果：所有结果评分和VAS疼痛评分在MACI后长达两年都显示出显着改善，而十年后的恢复则稳定了五年。迄今为止有两次失败，因此平均8年生存率为87％。 MRI显示修复组织的修复，在2年时的平均填充率为90％，在5年时的平均填充率为72％，在10年时的平均填充率为49％，并且所有患者在10年时均具有全厚度缺损86％的患者在5年时出现骨水肿，100 10％的患者中28％的患者在5年时有骨囊肿，10％的患者在10年时有100％的骨囊肿。十一例活检显示纤维软骨，四例显示透明质样软骨。 11例ICRS关节镜评分正常，3例接近正常评分，1例异常评分，但是80％的MACI移植物比周围关节软骨软。结论：结果评分是合理的，但在10年后会恶化，连续MRI显示移植物显着恶化，骨水肿和骨囊肿形成增加。在再镜检查时，80％的移植物柔软，73％的活检显示纤维软骨。 MACI微骨折后并不是孤立的软骨缺损的长期解决方案。

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