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Asode Ananthram Shetty,김석중,Vishvas Shetty,David Stelzeneder,Neha Shetty,Praveen Bilagi,이현진 한국조직공학과 재생의학회 2014 조직공학과 재생의학 Vol.11 No.3
We describe a single stage arthroscopic procedure for the treatment of articular cartilage defects in theknee. The novel procedure involves microfracture and application of bone marrow aspirate concentrate cells(BMAC) with hyaluronic acid and fibrin gel. The aim of the study was to evaluate the clinical and radiological out-comes at 2 years. A prospective study of 30 patients with symptomatic ICRS grade III/IV chondral defects, rangingfrom 2-9cm2, who were assessed clinically and radiologically. The surgical procedure involved debridement of thelesion, microfracture and application of concentrated BMAC with HA and fibrin gel under CO2 insufflation. Patientsunderwent morphological MRI, quantitative T2*-mapping and d-GEMRIC scan. Clinical assessment used the Lysh-olm, IKDC and KOOS scores. Radiological assessment used the MOCART score. At 2 year follow-up, Lysholmscore was 80.1, as compared to 50.8 pre-operatively (p<0.05). KOOS (symptomatic) was 92.1, as compared to 65.7pre-operatively. IKDC (subjective) was 83, up from 39 preoperatively. The mean T2* relaxation-times for the repairtissue and native cartilage were 29.1 and 29.9 respectively. Average MOCART score for all lesions was 72. Our tech-nique shows encouraging clinical results at 2 year follow-up. Clinical outcome scores show significant benefit. Themorphological MRI shows good cartilage defect filling and the biochemical MRI (T2*-mapping) suggests hyalinelike repair tissue.
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