II Clinic of Orthopaedic and Traumatology, Istituto Ortopedico Rizzoli, Bologna University, Via G.C. Pupilli 1, 40136, Bologna, Italy.
Knee Surg Sports Traumatol Arthrosc. 2013 Dec;21(12):2784-9. doi: 10.1007/s00167-012-2214-0. Epub 2012 Sep 27.
Knee arthrodesis is a scarcely tolerated procedure with a strong negative impact on the quality of life of the patient. The use of a fresh osteochondral allograft represents a fascinating option for a biological joint reconstruction. Aim of this report is to describe a case of total femoral and tibial osteochondral allograft used for reversing a non-tolerated knee fusion in a young patient and to report the clinical and radiographic results obtained at a 4-year follow-up.
A 22-year-old man with right knee arthrodesis received a reversion of the arthrodesis with a total femoral and tibial osteochondral allograft. Clinical and radiographical evaluations were carried out periodically up to 48 months.
At 48 months of follow-up, the patient had full integration of the allograft with a range of motion from 0° to 80°. Clinical scores improved from preoperative to final follow-up (IKDC from 25 to 65, KOOS from 32 to 65 and WOMAC from 30 to 74). Radiographic arthritis occurrence of the transplanted surfaces was evident at follow-up.
Despite the good clinical results achieved in the case described, a wider applicability of total femoral and tibial osteochondral allograft requires further studies on long-term larger allograft survival. Arthritis recurrence of the transplanted surfaces is cause of concern. Causes and possible solutions need to be more deeply investigated.
膝关节融合术是一种患者耐受性差、对生活质量有严重负面影响的手术。使用新鲜的骨软骨同种异体移植物是进行生物关节重建的一个有趣选择。本报告的目的是描述 1 例使用全股骨和胫骨骨软骨同种异体移植物来逆转年轻患者膝关节融合术的病例，并报告 4 年随访时获得的临床和影像学结果。
1 名 22 岁男性因右膝关节融合接受了全股骨和胫骨骨软骨同种异体移植物的逆转。定期进行临床和影像学评估，随访时间长达 48 个月。
在 48 个月的随访中，患者的移植物完全融合，活动度从 0°到 80°。临床评分从术前到最终随访时改善（IKDC 从 25 分提高到 65 分，KOOS 从 32 分提高到 65 分，WOMAC 从 30 分提高到 74 分）。随访时可见移植表面发生关节炎。
尽管在描述的病例中取得了良好的临床结果，但要更广泛地应用全股骨和胫骨骨软骨同种异体移植物，需要进一步研究长期、更大的移植物存活率。移植表面关节炎复发令人担忧。需要更深入地研究其原因和可能的解决方案。
