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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >LOOSE BODY VERSUS TROCHLEAR BIOPSY MATRIX-INDUCED AUTOLOGOUS CHONDROCYTE IMPLANTATION (MACI) MOCART SCORES AND IKDC REPORTED OUTCOMES IN PEDIATRIC PATIENTS
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LOOSE BODY VERSUS TROCHLEAR BIOPSY MATRIX-INDUCED AUTOLOGOUS CHONDROCYTE IMPLANTATION (MACI) MOCART SCORES AND IKDC REPORTED OUTCOMES IN PEDIATRIC PATIENTS

机译：松散的身体与Trochlear活检基质诱导的自体软骨细胞植入（MacI）Mocart评分和IKDC报告的儿科患者的结果

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Background: Third generation autologous chondrocyte implantation (ACI) has traditionally used biopsies from non-weightbearing sites within the knee for culture and growth. Given the potential risk of functional deficits from this procedure, other donor sites are being investigated. A recent study showed no difference in the viability of the MACI implant using biopsies from the standard intercondylar region compared to biopsies from the osteochondral loose body. However, clinical outcomes using these two different donor sites remains unknown. The purpose of this study was to asses differences in clinical outcomes as measured by Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART 2.0) and International Knee Documentation Committee (IKDC) scores at a minimum of 2 years post-implantation in patients who underwent a MACI procedure in the knee using cartilage grown from either the intercondylar notch or the osteochondral loose bodies. Methods: A retrospective study was performed on all ACI procedures from 2014 to 2017 at a single institution. Patients were split into two groups: one group having their cartilage derived from a standard intercondylar biopsy while the other group had their cartilage derived from osteochondral loose bodies. At a minimum 1-year post-implantation, MRIs of the implantation site were performed and three individual orthopaedic surgeons used the MOCART 2.0 knee score to assess the cartilage. Interclass correlation coefficients (ICC) were calculated between the 2 groups. IKDC scores were determined at a minimum 2 years after implantation. Differences between outcomes were compared using a Wilcoxon rank-sum test. Results: The intraclass coefficient between examiners for the MOCART scoring was excellent at 0.94. With regards to the MOCART score, the loose body group had a statistically insignificant 15-point lower median score at 65 (IQR 61-83) compared to the intercondylar group at 80 (IQR 60-89) (p=0.46). With regards to the IKDC, the loose body group had a statistically insignificant 1-point higher median score at 85 (IQR 69-96) compared to the intercondylar group at 84 (IQR 53-99) (p=0.79). Conclusions: This study demonstrates no difference in MOCART and patient reported outcomes in patients who had MACI from cartilage derived from either a standard intercondylar biopsy or an osteochondral loose body. Surgeons should be aware that using cartilage derived from osteochondral loose bodies is a viable option for MACI as it eliminates donor site morbidity and has comparable MOCART and functional outcomes at 2 years post-implantation compared to the standard intercondylar biopsy.
机译：背景：第三代自体软骨细胞植入（ACI）传统上使用了膝盖内的非重量位点的活组织检查，用于培养和生长。鉴于从该程序的潜在功能赤字的潜在风险，正在研究其他捐赠部位。最近的研究表明，与来自骨骨髓松散体的活组织检查相比，Maci植入物使用来自标准髁间区域的活组织检查没有差异。然而，使用这两个不同的供体部位的临床结果仍然未知。本研究的目的是通过软骨修复组织（MOCART 2.0）和国际膝关节委员会（IKDC）的磁共振观察（MOCART 2.0）和国际膝关节委员会（IKDC）分数来判断临床结果的差异，该委员会在接受MACI的患者中至少2年植入膝关节中的程序使用从跨跨度凹口或骨质色神经松散体种植的软骨。方法：对2014年至2017年的所有ACI程序进行了回顾性研究。患者分为两组：一组源自标准的间髁间活组织检查的软骨，而另一组源自骨质色神经松散体。在植入后至少1年，进行了植入部位的MRIS，三个单独的骨科外科医生使用MOCART 2.0膝关节分数来评估软骨。在2组之间计算杂机相关系数（ICC）。 IKDC分数在植入后至少2年确定。使用Wilcoxon Rank-Sum测试进行比较结果之间的差异。结果：MoCart评分检查者之间的颅内系数优异为0.94。关于Mocart评分，与80（IQR 60-89）的髁间基团相比，松散的体组在65（IQR 61-83）中具有统计学上微不足道的15点位数得分（IQR 61-83）（P = 0.46）。关于IKDC，与84（IQR 53-99）的跨跨度组相比，松散的体组在85（IQR 69-96）中具有统计上微不足道的1点钟中位数得分（IQR 69-96）（IQR 53-99）（P = 0.79）。结论：本研究表明，莫氏和患者患者的差异没有差异，这些患者患有来自标准髁间活组织检查或骨质色神经松散体的软骨。外科医生应该意识到，使用源自骨质色神经散发体的软骨是Maci的可行选择，因为它消除了与标准的间髁间体内植入术后2年的可比较的MoCart和功能性结果。

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