Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.
Arthroscopy. 2013 Feb;29(2):244-50. doi: 10.1016/j.arthro.2012.09.006.
The aim of this study was to evaluate the survival of microfractures in patients with degenerative osteoarthritic knees and to analyze the factors affecting length of time before total knee arthroplasty (TKA) is performed.
This study reviewed 134 knees in 124 patients in whom microfracture was performed and for whom a minimum of 10 years of follow-up data were available. Mean follow-up was 11.2 years. The survival rate was evaluated. Failure was defined as the need for TKA. Another definition of failure was substantial symptoms in a patient whose pain score during follow-up was lower than the preoperative pain score or <60. We evaluated factors affecting survival, including size of the cartilage defect and severity of the preoperative varus deformity. The mechanical axis percentage (MA%) was defined as the percentage by which the mechanical axis bisected the total width of the tibia.
The survival rate was 88.8% at 5 years and 67.9% at 10 years. Fifty-one patients proceeded to TKA a mean of 6.8 years after microfracture, and 6 knees were categorized as clinical failures. Age, gender, body mass index (BMI), and presence of meniscus lesions did not affect the survival of microfractures. Survival of microfractures in patients with a cartilage defect on the medial femoral condyle <2 cm(2) in size was better than that of microfractures in patients with larger defects. Survival of microfractures in patients with MA% >25% was better than that of patients with MA% <25%.
Among 134 knees, 51 knees (38.1%) proceeded to TKA a mean of 6.8 years after microfracture in this study, and 6 knees were categorized as clinical failures. The survival rate was 88.8% at 5 years and decreased over time to 67.9% at 10 years. When considering microfracture, surgeons must consider factors affecting survival, such as size of the cartilage defect and severity of the preoperative varus deformity.
Level IV, therapeutic case series.
本研究旨在评估退行性骨关节炎膝关节患者微骨折的存活率，并分析影响全膝关节置换术（TKA）时间的因素。
本研究回顾了 124 名患者的 134 例膝关节，这些患者接受了微骨折治疗，且至少有 10 年的随访数据。平均随访时间为 11.2 年。评估了生存率。失败的定义是需要 TKA。另一种失败的定义是患者的疼痛评分在随访期间低于术前疼痛评分或<60，且存在明显症状。我们评估了影响生存的因素，包括软骨缺损的大小和术前内翻畸形的严重程度。机械轴百分比（MA%）定义为机械轴将胫骨总宽度二等分的百分比。
5 年时的生存率为 88.8%，10 年时为 67.9%。51 例患者在微骨折后平均 6.8 年接受了 TKA，6 例膝关节被归类为临床失败。年龄、性别、体重指数（BMI）和半月板损伤的存在并不影响微骨折的存活率。股骨内侧髁软骨缺损<2cm2的患者的微骨折存活率优于缺损较大的患者。MA%>25%的患者的微骨折存活率优于 MA%<25%的患者。
在这项研究中，134 例膝关节中有 51 例（38.1%）在微骨折后平均 6.8 年接受了 TKA，有 6 例膝关节被归类为临床失败。5 年时的生存率为 88.8%，随着时间的推移，10 年时的生存率降至 67.9%。考虑微骨折时，外科医生必须考虑影响生存的因素，如软骨缺损的大小和术前内翻畸形的严重程度。
IV 级，治疗性病例系列。
