膝关节自体软骨细胞移植修复软骨缺损:MR成像评价生物力学指标  

Autologous chondrocyte transplantation for knee joint cartilage repair: MRI assessment of biomechanical changes

作　　者：郭红斌[1] 郭迎新 余伟[1] 丁春萍 蔡中立[4] 李民阳[5] 

机构地区：[1]南阳医学高等专科学校第一附属医院放射科,河南省南阳市473000 [2]社旗县人民医院神经内科,河南省南阳市473000 [3]南阳医学高等专科学校第三附属医院骨科,河南省南阳市473000 [4]南阳医学高等专科学校第一附属医院胸外科,河南省南阳市473000 [5]郑州大学附属第一医院骨一科,河南省郑州市450001

出　　处：《中国组织工程研究》2015年第51期8247-8252,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:磁共振(MR)检查目前被认为是关节软骨的最佳无创性检查方法,通过MR检查可以发现软骨损伤及软骨下骨病变。目的:磁共振成像观察膝关节软骨缺损自体软骨细胞移植修复后软骨生物力学指标变化。方法:回顾性分析10例膝关节软骨损伤患者临床资料,均接受自体软骨细胞移植治疗。移植后随访12个月,分别于移植后3,6,12个月对患者进行膝关节损伤与骨关节炎评分(KOOS)和磁共振成像检查,了解软骨生物力学指标变化情况。结果与结论:(1)膝关节损伤与骨关节炎评分:经比较,移植后3,6,12个月患者的疼痛、症状、日常活动、运动和娱乐、生活质量各项指标评分较移植前均出现显著提高(P<0.05)。(2)患者软骨生物力学MR成像:移植后3个月,患者的软骨缺损部位均大的部分得到良好的填充;移植后6个月,移植软骨与周围软骨基本处于完全整合状态;移植后12个月复查,修复组织信号强度与周围组织呈现出良好的一致现象。随着时间的推移,移植区的T2值呈现出不断下降的情况。且移植后3,6,12个月的T2值均显著小于移植前(P<0.05);移植后6,12个月的T2值均显著小于移植后3个月(P<0.05);移植前与移植后3个月,移植区的T2值均显著大于正常区(P<0.05)。结果表明,磁共振成像检查可以了解膝关节软骨缺损自体软骨细胞移植后不同时间软骨修复的生物力学情况,掌握治疗效果,是一种安全、无创的随访方式。BACKGROUND： MRI examination is considered as the best noninvasive method to detect the articular cartilage. Cartilage and subchondral bone defects can be detected through MRI examination. OBJECTIVE： To explore the biomechanical changes of the cartilage in articular cartilage defects of the knee after autologous chondrocyte transplantation through MRI examination. METHODS： The clinical data of 10 patients with articular cartilage defects who underwent autologous chondrocyte transplantation were analyzed retrospectively. All patients were followed up for 12 months, and the Knee Injury and Osteoarthritis Outcome Score（KOOS） and MRI examination were performed at 3, 6, 12 months after transplantation.RESULTS AND CONCLUSION： All the patients exhibited a great improvement in the KOOS scores in terms of pain, symptoms, daily activities, sports and entertainment, various indicators of quality of life at 3, 6 and 12 months after transplantation（P 〈 0.05）. MRI findings showed that the injured cartilage was mostly filled well at 3 months; the transplanted chondrocytes were basically integrated with the surrounding cartilage tissues at 6 months; the signal intensity of the repaired tissues was consistent with that of the surrounding tissues. As time went on, the T2 value of the transplanted area showed a continuous decline. Moreover, the T2 values at 3, 6 and 12 months after transplantation were significantly lower than that before transplantation（P 〈 0.05）; the T2 values at 6 and 12 months after transplantation were significantly less than that at 3 months after transplantation（P 〈 0.05）; the T2 values in the transplanted area before and 3 months after transplantation were significantly greater than those in the normal region（P 〈 0.05）. These findings indicate that MRI examination is a safe and noninvasive follow-up method to understand the biomechanical changes of the cartilage in articular cartilage defects of the knee after autologous chondrocyte transplantation and monitor the therapeu

关 键 词：膝关节 软骨 移植 磁共振成像 组织工程 组织构建 软骨组织工程 软骨缺损 自体软骨细胞移植术 生物力学 T2值 

分 类 号：R318[医药卫生—生物医学工程]