Taşer Omer, Cetinkaya Sarper, Kocabey Yavuz
Istanbul Universitesi Istanbul Tip Fakültesi Ortopedi ve Travmatoloji Anabilim Dali, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2007;41 Suppl 2:138-46.
The purpose of this retrospective analysis was to evaluate the management of chondral defects in knees with anterior cruciate ligament (ACL) disruption.
Twenty-seven patients (mean age 35 years; range, 20 to 48 years) were randomized to osteochondral autologous transplantation (OAT, n=14) or a microfracture (MF, n=13) procedure together with ACL reconstruction in the same session for symptomatic lesions of the articular cartilage in ACL-deficient knees. The mean follow-up period was 34 months (range 24 to 53 months) in the OAT group, and 49 months (range 24 to 97 months) in the MF group. Patients were evaluated using the Lysholm and IKDC 2000 (International Knee Documentation Committee) scores.
Patients undergoing OAT had a mean IKDC 2000 score of 49.2 (range 30.1 to 64.7), and Lysholm score of 43.4 (range 33.2 to 58.9) preoperatively. At the end of follow-up, these scores increased to 93.3 (range 73 to 98) and 97.5 (range 38.7 to 100), respectively. In the MF group, the mean IKDC 2000 score increased from 53.6 (range 47.1 to 64.7) to 72.3 (range 62.8 to 94), and the mean Lysholm score increased from 48 (range 38.2 to 58.9) to 81.3 (range 72.7 to 100).
Treatment of chondral lesions should be added to ACL reconstruction in unstable knees secondary to ACL deficiency.
本回顾性分析的目的是评估前交叉韧带（ACL）断裂的膝关节软骨损伤的处理方法。
27例患者（平均年龄35岁；范围20至48岁）被随机分为自体骨软骨移植组（OAT，n = 14）或微骨折组（MF，n = 13），并在同一次手术中进行ACL重建，用于治疗ACL缺失膝关节的关节软骨症状性损伤。OAT组的平均随访期为34个月（范围24至53个月），MF组为49个月（范围24至97个月）。使用Lysholm和IKDC 2000（国际膝关节文献委员会）评分对患者进行评估。
接受OAT治疗的患者术前IKDC 2000评分平均为49.2（范围30.1至64.7），Lysholm评分为43.4（范围33.2至58.9）。随访结束时，这些评分分别增至93.3（范围73至98）和97.5（范围38.7至100）。在MF组中，IKDC 2000评分平均从53.6（范围47.1至64.7）增至72.3（范围62.8至94），Lysholm评分平均从48（范围38.2至58.9）增至81.3（范围72.7至100）。
对于因ACL缺失导致不稳定的膝关节，应在ACL重建的基础上增加软骨损伤的治疗。
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