关节镜即时cemtrocell icc运动医学.pptx

ARTHROSCOPICMACIANDINSTANTCEMTROCELL(ICC)SymposiumSportsMedicine-OsteochondralDefects:TheGreatDebateProf.PedroGuillén;MD,PhDOrthopedicSurgeryDepartment,ResearchUnit,ClínicaCEMTRO,Madrid,Spain

ClínicaCEMTRO,Madrid

ClínicaCEMTRO,MadridBROKENL.M.ACUTECHONDRALLESION (22x18mm) MFC,RightKnee

ClínicaCEMTRO,MadridBROKENACLMILDCHONDRALLESIONLFM

ClínicaCEMTRO,MadridT2

MRI6monthMRI14month14months…aftersurgery… ICCforArthroscopy,May2009. JumppingEuropeChampion2010 Excellenteresult.

TREATMENTOFCHONDRALDEFECTSWITHCELLS:SECONDGENERATION Biomaterialdevelopment:useofacarriertotransportthecells(membranesoftypeI/IIIcollagen):ENGINEEREDTISSUEMACI(MembraneACI)

MATRIX-INDUCEDAUTOLOGOUS CHONDROCYTEIMPLANTATION(MACI)?MethodsimilartoACI?CellsseededontoacollagenI/III(1millionpercm2)

MACI:OUREXPERIENCE?174consecutivepatientswithdefectsinthearticularcartilageofthekneeorankle(between2001to2004)?CartilagebiopsytakenbyarthroscopyGenzyme?ArthroscopicMACIin50cases:46knee+4ankle?Meanage(+SD):35,7±9,9years?Sex:40(80%)maleand10(20%)female

LOCATIONOFTHEDEFECTS KNEEN=46Talus ANKLE N=44(100%)MedialCondyleLateralCondyleTrochlea31(67%)11(24%) 4(9%)

ARTHROSCOPICMACI20 060120 100 80KNEENoarthroscopy Arthroscopy4046 16ANKLE4108

OpenMACIArthroscopic MACIACI

TecniqueMACIarthroscopyMeasuringchondraldefectLesiónLFC1,4x1,4

SurgicalsetofinstrumentsClínicaCEMTROdeMadrid(Espa?a)

ClínicaCEMTRO,Madrid(Spain)BoneSuture

ARTHROSCOPICKNEEMACI

Numberofpatients MACI:FOLLOW-UP(PAIN)?Wehavefollow-upresultsin50patients?Meanfollow-upperiod:2years810323513210 5 01535302520BeforeSurgeryAfterSurgery6-10Painscale 0-3 3-6

PREVIOUSSURGERY921163105201510250surg.1surg.2surg.3surg.4surg.

69%80%70%60%50%40% IMPROVEMENTACCORDINGTO PREVIOUSSURGERY 89%90%30%20%10% 0% %GoodtoExcellentResultsP-value=0.1442