自發性膝關節缺血性壞死Spontaneous osteonecrosis of the knee (SONK)

自發性膝關節缺血性壞死Spontaneous osteonecrosis of the knee (SONK)

自發性膝關節缺血性壞死，常發生在年紀大的女性，通常是在膝關節的內側，會引起很嚴重的疼痛，原因是因為內側局部的壓力過大產生。

過去的治療方法，除了休息吃止痛藥之外，也常常使用骨頭減壓:把壞死的組織拿掉再鑽洞，看有沒有機會愈合。最近更流行:取病人的軟骨體外培養，做成軟骨體，再種植到壞死的部分，成功率也很好。也有些人會直接幫病人換人工關節，一勞永逸。但把軟骨做體外培養後，再種植到骨缺損處，常常所花的費用要四十萬，所費不眥。

最近福雅骨科使用板泌體直接注入關節(圖1)，奇妙事情發生:缺血性的部位竟然自動愈合(圖2,3)。此一發現可以改善病人的症狀外，也可以改變以後治療的方針:不需要再培養軟骨種植到骨缺損處，也不需要換人工關節。病人只要打針就可以解決他的問題，可說是一勞永逸。

英文版:

Spontaneous osteonecrosis of the knee (SONK) is a painful condition of unknown cause that leads to sudden onset of knee pain, often in older women, and usually affects the medial femoral condyle. It is believed to result from an insufficiency fracture in the weight-bearing bone, which can cause the bone to weaken, collapse, and lead to secondary osteoarthritis. Diagnosis is made with an MRI, and treatment ranges from non-operative measures like rest and pain medication to surgical procedures such as core decompression or joint replacement.

We found that injection of autologous conditioned serum can be effective in patients with spontaneous avascular necrosis of the knee. It can avoid the use of other methods such as artificial joint replacement, cartilage culture and transplantation, removal of necrotic tissue and drilling. just one to three injections of ACS can heal the disease.

  (圖一) 67歲女性，膝關節內髁缺血性壞死

  (圖二) 膝內注射板泌體一個月後

(圖三) 膝內注射板泌體三個月後