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[经皮钻孔治疗关节面病变]

[Treatment of joint surface pathology by Pridie drilling].

作者信息

Gudas Rimtautas, Simonaityte Rasa, Riauba Leonas, Pocius Gintautas, Kalesinskas Romas

机构信息

Kauno medicinos universiteto Ortopedijos ir traumatologijos klinika. Eiveniu 2, 3007 Kaunas.

出版信息

Medicina (Kaunas). 2002;38(7):720-9.

Abstract

This is an article of two homogenic groups treatment comparison, with 25 patients in each. Between 1998 and 2001 twenty-five patients underwent osteochondral or chondral fragment excision with Pridie tunelisations and 25 patients (controls)--osteochondral/chondral fragment excision alone (O-CFE). Average follow-up was 12.4 (range 10-14 months) and 23.6 months (range 22-25 months). All patients were younger than 30 years of age. Patients were evaluated through ICRS and modified HSS scales, arthroscopically, histologically and with x-rays. A blinded research assistant performed all follow-up evaluations. Sixteen of 25 (64%) tunelised (Pridie) results were good and 9 (36%)--fair at the time of last follow-up. Twelve of 25 (48%) in O-CFE group results were good and 12 (48%)--fair 23.6 months post operations. Final modified HSS evaluation showed statistically significantly better results in the Pridie group at the 12.4 and 23.6 months (p = 0.005). Last follow-up showed deterioration in both groups (p < 0.05). At an average 23.6 months follow-up x-rays showed initial osteoarthritis signs in the knees. Consequently, we recommend Pridie tunelisation procedure until final indications of cartilage grafting techniques will be established.

摘要

这是一篇关于两个同质性组治疗比较的文章,每组有25例患者。1998年至2001年间,25例患者接受了使用普里迪隧道成形术的骨软骨或软骨碎片切除术,另外25例患者(对照组)仅接受了骨软骨/软骨碎片切除术(O-CFE)。平均随访时间分别为12.4个月(范围10 - 14个月)和23.6个月(范围22 - 25个月)。所有患者年龄均小于30岁。通过国际软骨修复协会(ICRS)和改良的美国特种外科医院(HSS)评分量表、关节镜检查、组织学检查和X线检查对患者进行评估。由一名不知情的研究助理进行所有随访评估。在最后一次随访时,25例接受隧道成形术(普里迪)的患者中有16例(64%)结果良好,9例(36%)结果尚可。O-CFE组25例患者中有12例(48%)术后23.6个月结果良好,12例(48%)结果尚可。最终改良HSS评估显示,在12.4个月和23.6个月时,普里迪组的结果在统计学上显著更好(p = 0.005)。最后一次随访显示两组均有恶化(p < 0.05)。平均随访23.6个月时,X线显示膝关节出现早期骨关节炎迹象。因此,在软骨移植技术的最终指征确定之前,我们推荐使用普里迪隧道成形术。

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