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[微骨折技术治疗膝关节全层软骨损伤]

[The microfracture technique in the treatment of full-thickness chondral lesions of the knee].

作者信息

Alparslan Bülent, Ozkan Ilhan, Acar Ulaş, Cullu Emre, Savk S Oner

机构信息

Adnan Menderes Universitesi Tip Fakültesi Ortopedi ve Travmatoloji Anabilim Dali, Aydin, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2007;41 Suppl 2:62-9.

Abstract

OBJECTIVES

Chondral lesions of the knee joint present a difficult challenge because of their poor potential for spontaneous healing. In this study, we evaluated the results of the microfracture technique in the treatment of full-thickness chondral lesions.

METHODS

The study included 20 patients (12 males, 8 females; mean age 44 years; range 18 to 60 years) who were treated with the microfracture technique for 22 lesions of osteoarthritis or traumatic chondral injuries. The patients were evaluated at the end of a mean follow-up period of 3.8 years with a visual analog scale and Lysholm II scores. Wilcoxon signed-rank test was used for statistical analysis.

RESULTS

The size of the chondral lesions varied between 0.5 to 2.25 cm2. Most of the lesions were in the medial femoral condyle (n=11), followed by the medial femoral condyle and trochlear groove (n=4), the lower aspect of the patella (n=3), trochlear groove (n=3), and the lateral femoral condyle (n=1). The mean visual analog scale score was 69.5 (range 20 to 100) preoperatively and 11 (range 0 to 60) postoperatively (p<0.001). The mean Lysholm II score increased from a preoperative 73.7 (range 49 to 90) to a postoperative 86.1 (range 51 to 100) (p=0.017).

CONCLUSION

The microfracture technique is a method that relieves the symptoms, and results in considerable improvement in the function and activity of the patients with full-thickness chondral lesions. The advantages of this arthroscopic treatment method are cost-effectiveness and low morbidity rate.

摘要

目的

膝关节软骨损伤因其自愈能力差而带来了艰巨挑战。在本研究中,我们评估了微骨折技术治疗全层软骨损伤的效果。

方法

本研究纳入20例患者(男性12例,女性8例;平均年龄44岁;年龄范围18至60岁),他们因骨关节炎或创伤性软骨损伤的22处损伤接受了微骨折技术治疗。在平均随访3.8年结束时,采用视觉模拟评分法和Lysholm II评分对患者进行评估。采用Wilcoxon符号秩检验进行统计学分析。

结果

软骨损伤面积在0.5至2.25平方厘米之间。大多数损伤位于股骨内侧髁(n = 11),其次是股骨内侧髁和滑车沟(n = 4)、髌骨下方(n = 3)、滑车沟(n = 3)以及股骨外侧髁(n = 1)。术前视觉模拟评分法平均得分为69.5(范围20至100),术后为11(范围0至60)(p<0.001)。Lysholm II评分的平均值从术前的73.7(范围49至90)提高到术后的86.1(范围51至100)(p = 0.017)。

结论

微骨折技术是一种可缓解症状的方法,能使全层软骨损伤患者的功能和活动得到显著改善。这种关节镜治疗方法的优点是性价比高且发病率低。

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