[Advances in clinical repair techniques for localized knee cartilage lesions].

Publisher: Hua xi yi ke da xue Fu shu di 1 yi yuan Country of Publication: China NLM ID: 9425194 Publication Model: Print Cited Medium: Print ISSN: 1002-1892 (Print) Linking ISSN: 10021892 NLM ISO Abbreviation: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Subsets: MEDLINE

Publication: Chengdu Shi : Hua xi yi ke da xue Fu shu di 1 yi yuan
Original Publication: Chengdu Shi : Hua xi yi ke da xue Fu shu di 1 yi yuan,

Cartilage, Articular*/injuries ; Cartilage, Articular*/surgery ; Transplantation, Autologous* ; Chondrocytes*/transplantation ; Knee Injuries*/surgery ; Knee Joint*/surgery; Humans ; Bone Transplantation/methods ; Transplantation, Homologous ; Allografts ; Tissue Engineering/methods ; Plastic Surgery Procedures/methods

Objective: To summarize the classic and latest treatment techniques for localized knee cartilage lesions in clinical practice and create a new comprehensive clinical decision-making process.
Methods: The advantages and limitations of various treatment methods for localized knee cartilage lesions were summarized by extensive review of relevant literature at home and abroad in recent years.
Results: Currently, there are various surgical methods for treating localized knee cartilage injuries in clinical practice, each with its own pros and cons. For patients with cartilage injuries less than 2 cm ² and 2-4 cm ² with bone loss are recommended to undergo osteochondral autograft (OAT) and osteochondral allograft (OCA) surgeries. For patients with cartilage injuries less than 2 cm ² and 2-4 cm ² without bone loss had treatment options including bone marrow-based techniques (micro-fracture and ogous matrix induced chondrogenesis), autologous chondrocyte implantation (ACI)/matrix-induced ACI, particulated juvenile allograft cartilage (PJAC), OAT, and OCA. For patients with cartilage injuries larger than 4 cm ² with bone loss were recommended to undergo OCA. For patients with cartilage injuries larger than 4 cm ² without bone loss, treatment options included ACI/matrix-induced ACI, OAT, and PJAC.
Conclusion: There are many treatment techniques available for localized knee cartilage lesions. Treatment strategy selection should be based on the size and location of the lesion, the extent of involvement of the subchondral bone, and the level of evidence supporting each technique in the literature.

Cartilage. 2021 Dec;13(1_suppl):1187S-1194S. (PMID: 33106002)
Cartilage. 2020 Oct;11(4):447-457. (PMID: 30280586)
Arthroscopy. 2019 Jan;35(1):138-146. (PMID: 30473458)
Curr Rev Musculoskelet Med. 2015 Dec;8(4):429-35. (PMID: 26371073)
Knee Surg Sports Traumatol Arthrosc. 2017 Dec;25(12):3786-3799. (PMID: 27605128)
J Orthop. 2021 Feb 23;24:135-144. (PMID: 33716418)
Cartilage. 2010 Apr;1(2):78-86. (PMID: 26069538)
Indian J Orthop. 2023 Apr 8;57(6):975-982. (PMID: 37214380)
J Pers Med. 2024 Feb 20;14(3):. (PMID: 38540963)
Cell Prolif. 2021 Mar;54(3):e12998. (PMID: 33522652)
Trials. 2017 Nov 6;18(1):519. (PMID: 29110690)
Arthroscopy. 2020 Jan;36(1):289-303. (PMID: 31708355)
Acta Biochim Biophys Sin (Shanghai). 2023 May 12;55(5):701-712. (PMID: 37171185)
Am J Sports Med. 2016 Sep;44(9):2366-74. (PMID: 27298478)
Am J Sports Med. 2019 Jan;47(1):222-231. (PMID: 29161138)
Knee Surg Sports Traumatol Arthrosc. 2017 Oct;25(10):3186-3196. (PMID: 27539401)
Knee Surg Sports Traumatol Arthrosc. 2016 Dec;24(12):3912-3926. (PMID: 26003481)
Am J Sports Med. 2011 Nov;39(11):2355-61. (PMID: 21828366)
Am J Sports Med. 2018 Mar;46(4):826-831. (PMID: 29253350)
J Knee Surg. 2021 Dec;34(14):1609-1616. (PMID: 32483798)
Acta Biomater. 2021 May;126:170-182. (PMID: 33753316)
J Foot Ankle Surg. 2016 Mar-Apr;55(2):279-82. (PMID: 25201233)
J Exp Orthop. 2021 Jul 30;8(1):56. (PMID: 34331140)
J ISAKOS. 2022 Feb;7(1):39-46. (PMID: 35543659)
J Knee Surg. 2012 May;25(2):99-108. (PMID: 22928427)
Orthop Surg. 2023 Feb;15(2):549-562. (PMID: 36650102)
J Am Acad Orthop Surg. 2021 Nov 1;29(21):910-919. (PMID: 34293795)
J Clin Med. 2023 Oct 10;12(20):. (PMID: 37892577)
Arthroscopy. 2018 May;34(5):1498-1505. (PMID: 29395552)
Arthroscopy. 2012 Dec;28(12):1867-72. (PMID: 23084150)
J Knee Surg. 2012 Mar;25(1):23-9. (PMID: 22624244)
Int J Mol Sci. 2022 Apr 06;23(7):. (PMID: 35409424)
Orthop Traumatol Surg Res. 2021 Dec;107(8S):103075. (PMID: 34563735)

Keywords: Cartilage lesion; cartilage repair; clinical decision-making
Local Abstract: [Publisher, Chinese] 总结临床实践中膝关节局灶性软骨损伤的经典和最新治疗技术，创建新的综合临床决策流程。. [Publisher, Chinese] 广泛查阅国内外近年相关研究文献，总结膝关节局灶性软骨损伤各种治疗方法的优势和局限。. [Publisher, Chinese] 目前临床治疗膝关节局灶性软骨损伤的手术方式较多，各有利弊。对于<2 cm ² 和2～4 cm ² 伴有骨质丢失的软骨损伤患者，推荐采用自体骨软骨移植（osteochondral autograft，OAT）和同种异体骨软骨移植（osteochondral allograft，OCA）手术；<2 cm ² 和2～4 cm ² 不伴有骨质丢失的软骨损伤患者，手术选择包括基于骨髓的技术（微骨折和自体基质诱导软骨生成）、自体软骨细胞植入术（autologous chondrocyte implantation，ACI）/基质材料复合ACI、颗粒状幼年同种异体软骨移植技术（particulated juvenile allograft cartilage，PJAC）、OAT和OCA；>4 cm ² 伴有骨质丢失的软骨损伤患者首选OCA；而>4 cm ² 不伴有骨质丢失的软骨损伤患者，手术选择包括 ACI/基质材料复合ACI、OCA和PJAC。. [Publisher, Chinese] 膝关节局灶性软骨损伤有很多治疗技术可供选择；治疗策略应基于病变大小、病变位置、软骨下骨累及程度以及文献中支持每种技术的证据水平进行选择。.

Date Created: 20240716 Date Completed: 20240716 Latest Revision: 20240719

20240719

PMC11252692

10.7507/1002-1892.202402056

39013829