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自体软骨细胞移植治疗足球运动员关节软骨损伤:功能结果与重返赛场情况

Articular cartilage repair in soccer players with autologous chondrocyte transplantation: functional outcome and return to competition.

作者信息

Mithöfer Kai, Peterson Lars, Mandelbaum Bert R, Minas Tom

机构信息

Harvard Combined Orthopedic Surgery Program, Boston, Massachusetts, USA.

出版信息

Am J Sports Med. 2005 Nov;33(11):1639-46. doi: 10.1177/0363546505275647. Epub 2005 Aug 10.

Abstract

BACKGROUND

The ability of autologous chondrocyte transplantation to produce and maintain an effective articular cartilage repair under high mechanical demands has not been investigated.

HYPOTHESIS

Autologous chondrocyte transplantation provides a reliable and durable repair of full-thickness knee articular cartilage lesions in high-demand athletes.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

A total of 45 soccer players were evaluated 41 +/- 4 months after autologous chondrocyte transplantation for their ability to return to soccer, the timing of their return, skill level, and functional outcome rating by the Tegner activity rating scale score and Brittberg score. The factors influencing the return to sport were analyzed.

RESULTS

Of these players, 72% reported good to excellent results, with significant overall improvement of Tegner activity rating scale scores; 33% returned to soccer, including 83% of competitive-level players and 16% of recreational players. Of the returning players, 80% returned to the same skill level and 87% maintained their ability to play soccer at 52 +/- 8 months postoperatively. Players who successfully returned to soccer were significantly younger and had a shorter preoperative duration of symptoms than did patients who did not return to the sport. Concomitant adjuvant procedures did not adversely affect the ability to return to soccer.

CONCLUSION

Repair of knee articular cartilage lesions by autologous chondrocyte transplantation in high-performance athletes is particularly successful in younger, competitive athletes with limited preoperative intervals.

摘要

背景

自体软骨细胞移植在高机械需求下产生并维持有效关节软骨修复的能力尚未得到研究。

假设

自体软骨细胞移植能为高需求运动员的全层膝关节软骨损伤提供可靠且持久的修复。

研究设计

病例系列;证据等级,4级。

方法

对45名足球运动员在自体软骨细胞移植后41±4个月进行评估,内容包括他们恢复足球运动的能力、恢复时间、技能水平以及通过Tegner活动评分量表得分和Brittberg评分进行的功能结果评定。分析影响恢复运动的因素。

结果

这些运动员中,72%报告结果良好至优秀,Tegner活动评分量表得分总体有显著改善;33%恢复了足球运动,其中包括83%的竞技水平运动员和16%的休闲运动员。在恢复运动的运动员中,80%恢复到相同技能水平,87%在术后52±8个月保持了踢足球的能力。成功恢复足球运动的运动员比未恢复运动的患者明显更年轻,术前症状持续时间更短。同时进行的辅助手术并未对恢复足球运动的能力产生不利影响。

结论

在高性能运动员中,通过自体软骨细胞移植修复膝关节软骨损伤在术前间隔时间有限的年轻竞技运动员中尤为成功。

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