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青少年患者膝关节全层关节软骨损伤微骨折后的结果

Outcomes following microfracture of full-thickness articular cartilage lesions of the knee in adolescent patients.

作者信息

Steadman J Richard, Briggs Karen K, Matheny Lauren M, Guillet Alyson, Hanson Chad M, Willimon S Clifton

机构信息

Center for Outcomes-Based Orthopaedic Research, Steadman Philippon Research Institute, Vail, Colorado.

Desert Orthopaedic Center, Henderson, Nevada.

出版信息

J Knee Surg. 2015 Apr;28(2):145-50. doi: 10.1055/s-0034-1373737. Epub 2014 Apr 24.

Abstract

The purpose of this study was to document outcomes following microfracture for full-thickness cartilage defects of the knee in adolescents. Our hypothesis was that patients aged 18 years or less would have excellent outcomes and function following microfracture of full-thickness knee articular cartilage defects. This study was approved by the Institutional Review Board. Patients < 19 years old with full-thickness knee articular cartilage defects treated with microfracture between January 1992 and June 2008 were identified. Surgical, demographic data, Lysholm score, Tegner activity scale, and patient satisfaction were collected prospectively. A total of 26 patients (14 females, 12 males) met inclusion criteria. Average age was 16.6 years (range: 12-18.9 years). Ninety-six percent of lesions were patellar (37%) or femoral condyle defects (medial 26%, lateral 33%). Minimum 2-year follow-up was obtained in 22/26 patients (85%) with average follow-up of 5.8 years (range: 2.0-13.3 years). Average postoperative Lysholm score was 90 (range: 50-100). Median Tegner scale was 6 (range: 2-10). Median patient satisfaction with outcome was 10 (range: 1-10). Lysholm correlated with Tegner scale (rho = 0.586; p = 0.011) and patient satisfaction (rho = 0.70; p = 0.001). Average postoperative Lysholm score in males was 93 and 86 in females (p = 0.22). One patient underwent revision microfracture. This study showed that adolescent patients who underwent microfracture for treatment of full-thickness knee chondral defects demonstrated increased activity levels and excellent function following surgery.

摘要

本研究的目的是记录青少年膝关节全层软骨缺损微骨折术后的结果。我们的假设是,18岁及以下的患者在膝关节全层关节软骨缺损微骨折术后会有良好的结果和功能。本研究经机构审查委员会批准。确定了1992年1月至2008年6月期间接受微骨折治疗的19岁以下膝关节全层关节软骨缺损患者。前瞻性收集手术、人口统计学数据、Lysholm评分、Tegner活动量表和患者满意度。共有26例患者(14例女性,12例男性)符合纳入标准。平均年龄为16.6岁(范围:12 - 18.9岁)。96%的损伤为髌骨(37%)或股骨髁缺损(内侧26%,外侧33%)。26例患者中有22例(85%)获得了至少2年的随访,平均随访时间为5.8年(范围:2.0 - 13.3年)。术后平均Lysholm评分为90分(范围:50 - 100分)。Tegner量表中位数为6分(范围:2 - 10分)。患者对结果的满意度中位数为10分(范围:1 - 10分)。Lysholm评分与Tegner量表(rho = 0.586;p = 0.011)和患者满意度(rho = 0.70;p = 0.001)相关。男性术后平均Lysholm评分为93分,女性为86分(p = 0.22)。1例患者接受了翻修微骨折手术。本研究表明,接受微骨折治疗膝关节全层软骨缺损的青少年患者术后活动水平提高,功能良好。

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