Autologous chondrocyte implantation for the treatment of cartilage lesions of the knee: a systematic review of randomized studies

被引:81
作者
Vasiliadis, Haris S. [1 ,2 ]
Wasiak, Jason [3 ,4 ]
Salanti, Georgia [5 ]
机构
[1] Univ Ioannina, Sch Med, Dept Orthopaed, Orthopaed Sports Med Ctr, GR-45110 Ioannina, Greece
[2] Gothenburg Univ, Sahlgrenska Univ Hosp, Gothenburg, Sweden
[3] Monash Univ, Alfred Hosp, Victorian Adult Burns Serv, Melbourne, Vic 3181, Australia
[4] Monash Univ, Alfred Hosp, Sch Publ Hlth & Preventat Med, Melbourne, Vic 3181, Australia
[5] Univ Ioannina, Sch Med, Dept Hyg & Epidemiol, Clin & Mol Epidemiol Unit, GR-45110 Ioannina, Greece
基金
欧洲研究理事会;
关键词
Cartilage; Chondrocyte implantation; Knee; Repair; Chondral; Systematic review; OSTEOCHONDRAL DEFECTS; COLLAGEN MEMBRANE; CHONDRAL DEFECTS; REPAIR; TRANSPLANTATION; MICROFRACTURE; MOSAICPLASTY; TRIAL;
D O I
10.1007/s00167-010-1050-3
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Autologous chondrocyte implantation (ACI) techniques are becoming more popular for the treatment of full thickness cartilage lesions of the knee joint. However, there is no systematic information for the efficacy of the new generation ACI techniques compared to other treatment options. A systematic review of the existing evidence from randomized clinical trials of ACI treatment would contribute to understanding the advantages and limitations of this method and would inform the planning of future studies. Using pre-defined criteria, we searched a number of electronic databases to identify all the existing randomized control trials of any type of ACI treatment. Risk of bias was assessed and an analysis of the reported outcomes was performed. Information on the clinical efficacy and safety of ACI compared to other interventions was collected and presented. Nine trials were identified with 626 patients. Patients ranged from 15 to 52 years, and the size of treated lesions was between 1 and 22 cm(2). ACI was associated with improvement in clinical outcomes compared to baseline. However, the body of evidence did not suggest any superiority of ACI over other treatments. Complication rates were comparable between interventions except from an increased rate of graft hypertrophies after ACI with periosteum. ACI is an effective treatment for full thickness chondral defects of the knee, providing an improvement of clinical outcomes. However, there is insufficient data to say whether ACI is superior to other treatment strategies. More high quality studies and harmonization in the reported outcomes are needed before specific suggestions for practice can be made.
引用
收藏
页码:1645 / 1655
页数:11
相关论文
共 42 条
[1]   Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee [J].
Bartlett, W ;
Skinner, JA ;
Gooding, CR ;
Carrington, RWJ ;
Flanagan, AM ;
Briggs, TWR ;
Bentley, G .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2005, 87B (05) :640-645
[2]   Autologous chondrocyte implantation at the knee using a bilayer collagen membrane with bone graft - A preliminary report [J].
Bartlett, W ;
Gooding, CR ;
Carrington, RWJ ;
Skinner, JA ;
Briggs, TWR ;
Bentley, G .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2005, 87B (03) :330-332
[3]  
Basad E., 2004, ORTHOPADISCHE PRAXIS, V40, P6
[4]   A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee [J].
Bentley, G ;
Biant, LC ;
Carrington, RWJ ;
Akmal, M ;
Goldberg, A ;
Williams, AM ;
Skinner, JA ;
Pringle, J .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2003, 85B (02) :223-230
[5]   TREATMENT OF DEEP CARTILAGE DEFECTS IN THE KNEE WITH AUTOLOGOUS CHONDROCYTE TRANSPLANTATION [J].
BRITTBERG, M ;
LINDAHL, A ;
NILSSON, A ;
OHLSSON, C ;
ISAKSSON, O ;
PETERSON, L .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (14) :889-895
[6]   Autologous chondrocyte implantation-technique and long-term follow-up [J].
Brittberg, Mats .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2008, 39 :S40-S49
[7]  
Browne J E, 2000, J Am Acad Orthop Surg, V8, P180
[8]   Cartilage injuries: A review of 31,516 knee arthroscopies [J].
Curl, WW ;
Krome, J ;
Gordon, ES ;
Rushing, J ;
Smith, BP ;
Poehling, GG .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 1997, 13 (04) :456-460
[9]  
Dozin B, 2005, CLIN J SPORT MED, V15, P218
[10]  
FICAT RP, 1979, CLIN ORTHOP RELAT R, P74