Biological, functional and radiographic evaluation of autologous chondrocyte implantation

自体软骨细胞植入的生物学、功能和放射学评估

• 批准号: nhmrc : 254743
• 负责人: Prof David Wood
• 金额: $ 20.5万
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Development Grants
• 财政年份: 2003
• 资助国家: 澳大利亚
• 起止时间: 2003-01-01 至 2005-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/biological-functional-radiographic-chondrocyte-implantation/97059
• 关键词: Biological; functional; radiographic; evaluation; autologous

We will test the hypothesis that autologous chondrocyte implantation (ACI) and extensor realignment produces superior clinical, biological and radiographic results when compared with conventional treatment of realignment and debridement. We will specifically address the following aims: 1. Quantify the clinical outcome of ACI compared to the traditionally used treatment of debridement through the use of functional evaluation in a blinded randomised controlled clinical trial; 2. Evaluate the radiographic changes in the patellofemoral joint that occur as a result of ACI, using high resolution magnetic resonance imaging (MRI) to quantify the regeneration of hyaline articular cartilage; 3. Using the new technique of confocal arthroscopy, we will compare the histologic appearances of the ACI graft and its interface with adjacent articular cartilage; 4. Evaluate patient, surgical and explant chondrocyte characteristics in relation to functional, radiographic and biological outcomes. With respect to the matrix-induced autologous chondrocyte implantation (MACI) technique, we wish to clarify the clinical practice as a definitive treatment for articular cartilage defects. This will be the first randomised, controlled clinical trial of the MACI technique compared to that used by other groups. A positive clinical outcome from this trial will help promote the three cornerstones of this procedure – successful cell culture, efficient surgical procedures, and complimentary postoperative rehabilitation. Furthermore, this research will: a) Enhance the expansion of the MACI technique; b) Encourage development of endoscopic techniques of implantation using a combination of – • Preoperative defect registration with MRI • pre-cut custom patches, implanted with • Computer-assisted navigation techniques: c) Increase the potential to cater for a larger number of patients requiring articular cartilage repair; d) Confirm the long-term durability of regenerated cartilage in the 4th year and beyond; e) Add further commercial value by demonstrating MACI may prevent the onset of osteoarthritis.

我们将检验以下假设：与传统的重新排列和清创治疗相比，自体软骨细胞植入 (ACI) 和伸肌重新排列可产生更好的临床、生物学和放射学结果。我们将具体解决以下目标： 1. 量化比较 ACI 的临床结果。通过在盲法随机对照临床试验中使用功能评估来改变传统的清创治疗方法； 2. 评估髌股关节的放射学变化； 3. 使用共聚焦关节镜新技术，我们将比较 ACI 移植物及其界面与邻近软骨的组织学外观；关节软骨；4. 评估与基质诱导的自体软骨细胞植入相关的患者、手术和外植软骨细胞特征。 (MACI) 技术，我们希望阐明作为关节软骨缺陷的确定性治疗方法的临床实践，与其他组使用的技术相比，这将是第一个随机、对照的临床试验。将有助于促进该手术的三个基石——成功的细胞培养、高效的外科手术和免费的术后康复。的组合– • 术前使用 MRI 进行缺损登记 • 预先切割的定制贴片，植入 • 计算机辅助导航技术： c) 增加满足大量需要关节软骨修复的患者的潜力 d) 确认关节软骨的长期耐用性；第四年及以后再生软骨； e) 通过证明 MACI 可以预防骨关节炎的发作，增加进一步的商业价值。