Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2006; 73(6):373-379 | DOI: 10.55095/achot2006/057

Léčba hlubokých chondrálních defektů pately transplantací kultivovaných autologních chondrocytůPůvodní práce

M. HANDL^1,*, T. TRČ¹, M. HANUS¹, E. ŠŤASTNݹ, M. FRICOVÁ-POULOVÁ², J. NEUWIRTH², J. ADLER³, D. HAVRANOVÁ³, F. VARGA⁴

¹ Ortopedická klinika dětí a dospělých 2.LF UK a FN Motol, Praha

² Klinika zobrazovacích metod, 2.LF UK a FN Motol, Praha

³ Tkáňová banka, FN Brno - Bohunice

⁴ Oddělení biofyziky 2. LF UK a FN Motol, Praha

PURPOSE OF THE STUDY:
The aim of this study was to present the results of treatment of deep chondral defects of the patella by transplantation of a solid chondral graft formed by autologous cultured chondrocytes.

MATERIAL AND METHODS:
Indications for autologous chondrocyte implantation most frequently included acute trauma to the knee, particularly the patella, which resulted in a severe focal cartilage defect. The lesions were assessed on the basis of the Bessette and Hunter classification preoperatively, and on the Outerbridge classification during arthroscopy. A sample of healthy cartilage was harvested from a non-weight-bearing area of the trochlea femoris. After cultivation of chondrocytes for 28 to 42 days in the tissue bank, a solid chondral graft, prepared with the use of fibrin glue (Tissucol), was ready for implantation.

RESULTS:
Six patients, two males and four females (average age, 21.1 years; range, 13 to 39 years) were treated by this method in the period from July 2003 to October 2005. Follow-up ranged from 1 to 25 months, with an average of 18.5 months. The patients were examined postoperatively by magnetic resonance imaging (MRI) at 2 weeks, 2 and 6 months, and at 1 year. The clinical results were evaluated by the Meyers, the Tegner and the Lysholm knee scoring systems. Two of the six patients, in whom the follow-up period was shorter than 6 months, were not included in the evaluation.

CONCLUSIONS:
A significant improvement in knee function was recorded when the preoperative and final follow-up stages were compared, as well as on comparison with the healthy contralateral knee joint. MRI examination showed good graft incorporation in all patients.

Klíčová slova: patella, chondrocytes, cartilage transplantation

Přijato: 18. červenec 2006; Zveřejněno: 1. prosinec 2006  Zobrazit citaci