Gomoll Andreas H, Kang Richard W, Chen Andrea L, Cole Brian J
Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, USA.
J Knee Surg. 2009 Apr;22(2):137-41. doi: 10.1055/s-0030-1247738.
Arthritis treatment in young patients remains a challenge. Joint replacement surgery offers excellent pain relief but is controversial with this age group because of long-term wear and loosening. Recently, biological reconstructive techniques have become available to improve traditional treatment methods such as osteotomies. We present our experience with a technique for combined meniscal transplantation, chondral repair, and osteotomy in 7 patients presenting with a constellation of meniscal deficiency, focal arthritis, and malalignment. Patients underwent concurrent or staged meniscal transplantation, cartilage repair, and osteotomy. Evaluation included the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Short Form-12 and Lysholm scales. At average follow-up of 24 months, patients experienced significant improvements in the IKDC, Lysholm, and KOOS functional scores. Six of 7 patients were able to return to unrestricted activities; 1 patient experienced mild pain with high-impact activities. Combined treatment with meniscal transplantation, cartilage repair, and osteotomy demonstrated promising clinical results of unicompartmental arthritis treatment in young patients.
年轻患者的关节炎治疗仍然是一项挑战。关节置换手术能有效缓解疼痛，但由于长期磨损和松动问题，在这个年龄组中存在争议。最近，生物重建技术已可用于改进传统治疗方法，如截骨术。我们介绍了我们对7例伴有半月板缺损、局灶性关节炎和对线不良的患者采用半月板移植、软骨修复和截骨术联合技术的经验。患者接受了同期或分期的半月板移植、软骨修复和截骨术。评估包括国际膝关节文献委员会（IKDC）评分、膝关节损伤和骨关节炎疗效评分（KOOS）以及简短健康调查问卷12项（Short Form-12）和Lysholm量表。平均随访24个月时，患者的IKDC、Lysholm和KOOS功能评分有显著改善。7例患者中有6例能够恢复无限制活动；1例患者在进行高强度活动时出现轻度疼痛。半月板移植、软骨修复和截骨术联合治疗在年轻患者单髁关节炎治疗中显示出有前景的临床效果。
