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首页> 外文期刊>Cartilage >Treatment of Hemophilic Ankle Arthropathy with One-Step Arthroscopic Bone Marrow–Derived Cells Transplantation
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Treatment of Hemophilic Ankle Arthropathy with One-Step Arthroscopic Bone Marrow–Derived Cells Transplantation

机译：一步式关节镜骨髓来源的细胞移植治疗血友病性踝关节病

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摘要

Objective. Ankle arthropathy is a frequent and invalidating manifestation of hemophilia. Arthrodesis is the gold standard surgical procedure in end-stage disease, with many drawbacks in young patients. Recent literature has shown increase interest in regenerative procedures in hemophilic arthropathy, which may be desirable to delay or even avoid arthrodesis. The aim of this article is to present five cases of osteochondral lesions in ankle hemophilic arthropathy treated with a regenerative procedure: bone marrow-derived cells transplantation (BMDCT). Design. We report five hemophilic patients (four cases with hemophilia type A; one case with hemophilia type B) who have undergone BMDCT treatment, synovectomy, and arthroscopic debridement, with the use of autologous platelet-rich fibrin, to treat osteochondral lesions in hemophilic ankle arthropathy. The patients, included within this retrospective study, were clinically and radiologically evaluated with serial follow-ups, using the American Orthopaedic Foot and Ankle Society (AOFAS) scores, radiographs, and magnetic resonance imaging (MRI). Results. The mean preoperative AOFAS score was 35. After a mean follow-up of 2 years, the mean postoperative AOFAS score was 81, which included three patients returning back to sporting activities. The MRI Mocart score demonstrated signs of regeneration of chondral and bony tissue. No progression of joint degeneration was shown radiographically. Conclusion. BMDGT is a promising regenerative treatment for osteochondral lesions in mild ankle hemophilic arthropathy, which may be useful to delay or even avoid ankle arthrodesis. Nevertheless, longer follow-ups and a larger case series are required.
机译：目的。踝关节病是血友病的常见且无效的表现。关节固定术是终末期疾病的金标准手术程序，在年轻患者中有许多缺点。最近的文献表明对血友病性关节炎的再生程序越来越感兴趣，这对于延迟甚至避免关节病是理想的。本文的目的是介绍5例再生疗法治疗的踝关节血友病性骨软骨病：骨髓来源的细胞移植（BMDCT）。设计。我们报告了5例血友病患者（4例A型血友病; 1例B型血友病），他们接受了BMDCT治疗，滑膜切除术和关节镜清创术，并使用自体富含血小板的纤维蛋白治疗血友病性踝关节病的骨软骨病变。使用美国矫形足踝学会（AOFAS）评分，X线照片和磁共振成像（MRI），对患者进行回顾性临床和放射学评估，并进行系列随访。结果。术前AOFAS评分平均为35分。平均随访2年后，术后AOFAS评分平均为81分，其中包括三名恢复运动的患者。 MRI Mocart评分显示出软骨和骨组织再生的迹象。影像学检查未见关节退变的进展。结论。 BMDGT是治疗轻度踝关节血友病性骨软骨病变的有前途的再生疗法，可能有助于延迟甚至避免踝关节置换术。尽管如此，仍需要更长的随访时间和更大的病例系列。

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