Alparslan Bülent, Ozkan Ilhan, Acar Ulaş, Cullu Emre, Savk S Oner
Adnan Menderes Universitesi Tip Fakültesi Ortopedi ve Travmatoloji Anabilim Dali, Aydin, Turkey.
Acta Orthop Traumatol Turc. 2007;41 Suppl 2:62-9.
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.
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.
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).
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.
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。
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。
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)。
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。