Mithoefer Kai, Williams Riley J, Warren Russell F, Wickiewicz Thomas L, Marx Robert G
Harvard Vanguard Orthopedics and Sports Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Am J Sports Med. 2006 Sep;34(9):1413-8. doi: 10.1177/0363546506288240. Epub 2006 May 30.
Knee articular cartilage injuries in athletes present a therapeutic challenge and have been identified as an important cause of permanent disability because of the high mechanical joint stresses in athletes.
To determine whether microfracture treatment of knee articular cartilage injuries can return athletes to high-impact sports and to identify the factors that affect the ability to return to athletic activity.
Case series; Level of evidence, 4.
Thirty-two athletes who regularly participated in high-impact, pivoting sports before articular cartilage injury were treated with microfracture for single articular cartilage lesions of the knee. Functional outcome was prospectively evaluated with a minimum 2-year follow-up by subjective rating, activity-based outcome scores, and the ability for postoperative participation in high-impact, pivoting sports.
At last follow-up, 66% of athletes reported good or excellent results. Activity of daily living, Marx activity rating scale, and Tegner activity scores increased significantly after microfracture. After an initial improvement, score decreases were observed in 47% of athletes. Forty-four percent of athletes were able to regularly participate in high-impact, pivoting sports, 57% of these at the preoperative level. Return to high-impact sports was significantly higher in athletes with age <40 years, lesion size <200 mm(2), preoperative symptoms <12 months, and no prior surgical intervention.
Microfracture is an effective first-line treatment to return young athletes with short symptomatic intervals and small articular cartilage lesions of the knee back to high-impact athletics.
运动员膝关节软骨损伤带来了治疗挑战，并且由于运动员关节承受的机械应力较高，已被确定为永久性残疾的重要原因。
确定膝关节软骨损伤的微骨折治疗能否使运动员恢复高强度运动，并确定影响恢复运动能力的因素。
病例系列；证据等级，4级。
32名在关节软骨损伤前经常参加高强度旋转运动的运动员接受了膝关节单关节软骨损伤的微骨折治疗。通过主观评分、基于活动的结果评分以及术后参与高强度旋转运动的能力，对功能结果进行了前瞻性评估，随访至少2年。
在最后一次随访时，66%的运动员报告结果良好或优秀。微骨折后，日常生活活动、马克思活动评分量表和特格纳活动评分均显著提高。在最初改善后，47%的运动员评分下降。44%的运动员能够定期参加高强度旋转运动，其中57%达到术前水平。年龄<40岁、损伤面积<200 mm²、术前症状<12个月且无既往手术干预的运动员恢复到高强度运动的比例显著更高。
微骨折是一种有效的一线治疗方法，可使症状持续时间短且膝关节软骨损伤小的年轻运动员恢复高强度运动。
