Objective To evaluate the clinical results of fibrin matrix-mixed gel-type ACI (G-ACI)during postoperative cartilage repair.Methods A 48-year-old female patient who had cartilage defects in the patella (1.8 cm×3.0 cm) and medial condyle (0.5 cm×0.5 cm) was selected. Both defects belonged to Outerbridge/ICRS Ⅲ-Ⅳ. We began by harvesting 50 mg cartilage from the non-bearing region and had it cultured at the GMP lab of the General Hospital. After 6 months, the autologous chondrocytes and gel scafford were implanted into the defective region by arthrotomy. T1 Vibe MRI, T2 Mapping MRI and Knee Injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate the result of clinical rehabilitation in 6 mon, 1 y and 1.5 y postoperatively.Results The earliest signs of proliferation of chondrocytes in the transplant area were seen 6 mon postoperatively as shown by T1 Vibe MRI. Newborn chondrocytes filled the transplant area completely till 1.5 years after operation. T2 Mapping MRI showed a reconstruction process of newborn chondrocytes. T2 Mapping values decreased after operation. All the items in KOOS progressively improved after G-ACI operation, but faster recovery occurred between six months and one year postoperatively.Conclusions G-ACI can reduce surgical difficulties without cutting and suturing while facilitating attachment, thus it can be easily performed under arthroscopy regardless of the site, shape and depth of defects. We have achieved good outcomes postoperatively during early follow-up. G-ACI appears to be a safe and effective method to repair cartilage defects of knees.
丁一,郑静晨,张仲文. 国内首例凝胶基质自体软骨细胞移植治疗膝关节软骨损伤及文献回顾[J]. 武警医学, 2018, 29(6): 599-602.
DING Yi,ZHENG Jingchen, ZHANG Zhongwen.. Fibrin matrix-mixed gel-type autologous chondrocyte implantation for knee cartilage repair in China: the first case report and literature review. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(6): 599-602.
Bozkurt M, Isik C, Gursoy S, et al. Bilayer Matrix Autologous Chondrocyte Implantation without Bone Graft for Knee Osteochondral Lesion less than 8 mm Deep[J]. J Knee Surg, 2017,12: 28.
[2]
Ebert J R, Schneider A, Fallon M, et al. A Comparison of 2-Year Outcomes in Patients Undergoing Tibiofemoral or Patellofemoral Matrix-Induced Autologous Chondrocyte Implantation[J]. Am J Sports Med, 2017, 45(14): 3243-3253.
[3]
Adachi N,Ochi M,Deie M, et al. Implantation of tissue-engineered cartilage-like tissue for the treatment for full-thickness cartilage defects of the knee[J]. Knee Surg Sports Tr,2014, 22(6): 1241-1248.
[4]
Munirah S, Samsudin OC, Chen HC, et al. Articular cartilage restoration in loadbearing osteochondral defects by implantation of autologous chondrocyte-fibrin constructs: an experimental study in sheep[J]. J Bone Jt Surg Br, 2007, 89(8): 1099-1109.
[5]
Lee K T,Kim J S,Young K W, et al. The use of fibrin matrix-mixed gel-type autologous chondrocyte implantation in the treatment for osteochondral lesions of the talus[J]. Knee Surg Sports Tr,2013, 21(6): 1251-1260.
[6]
Choi N Y,Kim B W,Yeo W J, et al. Gel-type autologous chondrocyte (ChondronTM) implantation for treatment of articular cartilage defects of the knee[J]. BMC Musculoskelet Disord,2010,28;11:103.
[7]
Van Duijvenbode DC,Jonkers FJ,K?nst YE, et al. Gel-type autologous chondrocyte implantation for cartilage repair in patients with prior ACL reconstruction: a retrospective two year follow-up[J]. Knee,2016, 23(2): 241-245.
Huh S W,Shetty A A,Ahmed S, et al. Autologous bone-marrow mesenchymal cell induced chondrogenesis(MCIC)[J]. J Clin Orthop Trauma,2016, 7(3): 153-156.
[10]
Jang J D, Moon Y S, Kim Y S, et al. Novel repair technique for articular cartilage defect using a fibrin and hyaluronic acid mixture[J]. Tissue Eng Regen Med, 2013, 10:1.
[11]
Kim M K,Choi S W,Kim S R,et al. Autologous chondrocyte implantation in the knee using fibrin[J]. Knee Surg Sports Traumatol Arthrosc,2010, 18(4): 528-534.
[12]
Zhong X, Zhang Z W, Wang H, et al. Two-year MRI folowing up after matrix-induced autologous chondrocyte implantation of the knee[J]. Chin J Med Imaging Technol, 2012, 28(6): 1199-1203.
[13]
Zhang Z,Zhong X,Ji H,et al. Matrix-induced autologous chondrocyte implantation for the treatment of chondral defects of the knees in Chinese patients[J]. Drug Des Devel Ther,2014, 8: 2439-2348.
[14]
Domayer S E,Welsch G H,Nehrer S, et al. T2 mapping and dGEMRIC after autologous chondrocyte implantation with a fibrin-based scaffold in the knee: preliminary results[J]. Eur J Radiol,2010, 73(3): 636-642.
[15]
Kreuz P C,Müller S,von Keudell A,et al. Influence of sex on the outcome of autologous chondrocyte implantation in chondral defects of the knee[J]. Am J Sports Med,2013, 41(7): 1541-1548.
2018, Vol. 29 
