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关节镜下逆行骨软骨自体移植治疗胫骨平台软骨病变:一项前瞻性研究。

Arthroscopic retrograde osteochondral autograft transplantation for cartilage lesions of the tibial plateau: a prospective study.

机构信息

Cabinet Goethe, 23 Avenue Niel, 75017 Paris, France.

出版信息

Am J Sports Med. 2013 Feb;41(2):411-5. doi: 10.1177/0363546512469091. Epub 2012 Dec 13.

DOI:10.1177/0363546512469091
PMID:23239669
Abstract

BACKGROUND

There are only 2 reported cases of arthroscopic retrograde osteochondral autograft transplantations regarding tibial plateau cartilage defects.

PURPOSE

To present a detailed description of arthroscopic retrograde osteochondral autograft transplantation of the tibial plateau as well as to provide its advantages and disadvantages in comparison with other techniques.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Four patients (3 men and 1 woman; mean age, 31.2 years) suffering from tibial plateau cartilage lesions underwent surgery. In each case, the lesions were caused by sports injuries. There were 3 lateral and 1 medial tibial plateau defects. The International Knee Documentation Committee (IKDC) score and Knee injury and Osteoarthritis Outcome Score (KOOS) were recorded preoperatively and postoperatively. Radiological assessment was made by plain radiographs, CT arthroscans, and MRI.

RESULTS

The mean follow-up was 55 months (range, 52-60). The mean preoperative IKDC score was 53.5 (range, 37-66), while the mean postoperative IKDC score at final follow-up was 95.4 (range, 93.1-97.7). Regarding the KOOS calculation, there was significant improvement concerning each parameter after surgery. All patients were satisfied with the surgical procedure and returned to their previous activity level. Postoperative imaging showed very good adaptation and incorporation of the osteochondral autografts.

CONCLUSION

Treatment of tibial plateau cartilage defects with arthroscopic retrograde osteochondral autograft transplantation could be performed on a routine basis in clinical practice. The results were encouraging and showed good incorporation of the graft, a minimal failure rate, and satisfactory functional outcomes of patients.

摘要

背景

仅有 2 例关于胫骨平台软骨缺损的关节镜下逆行骨软骨自体移植的报道。

目的

详细描述胫骨平台关节镜下逆行骨软骨自体移植,并与其他技术相比,阐述其优缺点。

研究设计

病例系列;证据水平,4 级。

方法

4 例(3 男 1 女;平均年龄 31.2 岁)运动损伤导致胫骨平台软骨病变的患者接受了手术。在每种情况下,病变均由运动损伤引起。外侧胫骨平台有 3 个缺陷,内侧胫骨平台有 1 个缺陷。术前和术后记录国际膝关节文献委员会(IKDC)评分和膝关节损伤和骨关节炎结果评分(KOOS)。影像学评估采用普通 X 线、CT 关节造影和 MRI。

结果

平均随访 55 个月(范围,52-60)。术前 IKDC 平均评分为 53.5(范围,37-66),而最终随访时的术后 IKDC 平均评分为 95.4(范围,93.1-97.7)。关于 KOOS 计算,手术后每个参数都有显著改善。所有患者对手术过程均满意,并恢复到术前的活动水平。术后影像学显示,骨软骨自体移植物的适应性和融合性非常好。

结论

关节镜下逆行骨软骨自体移植治疗胫骨平台软骨缺损可在临床实践中常规进行。结果令人鼓舞,显示出移植物良好的融合、较低的失败率以及患者满意的功能结果。

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