Gelber Pablo Eduardo, Batista Jorge, Millan-Billi Angélica, Patthauer Luciano, Vera Silvia, Gomez-Masdeu Mireia, Monllau Juan Carlos
ICATME-Hospital Universitari Quirón-Dexeus, Universitat Autònoma de Barcelona, Sabino de Arana 5-19, 08028 Barcelona, Spain; Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Quintí 89, 08041 Barcelona, Spain.
Centro Artroscópico Jorge Batista S.A., Pueyrredón 2446 5° B, C1119ACU Ciudad Autónoma de Buenos Aires, Argentina.
Knee. 2014 Aug;21(4):827-32. doi: 10.1016/j.knee.2014.04.013. Epub 2014 May 9.
Treatment of osteochondral lesions of the knee with synthetic scaffolds seems to offer a good surgical option preventing donor site morbidity. The TruFit® plug has frequently been shown to not properly incorporate into.
To evaluate the relationship between MRI findings and functional scores of patients with osteochondral lesions of the knee treated with TruFit®.
Patients were evaluated with MOCART score for magnetic resonance imaging assessment of the repair tissue. KOOS, SF-36 and VAS were used for clinical evaluation. Correlation between size of the treated chondral defect and functional scores was also analyzed.
Fifty-seven patients with median follow-up of 44.8 months (range 24-73) were included. KOOS, SF-36 and VAS improved from a mean 58.5, 53.9 and 8.5 points to a mean 87.4, 86.6 and 1.2 at last follow-up (p<0.001). Larger lesions showed less improvement in KOOS (p=0.04) and SF-36 (p=0.029). Median Tegner values were restored to preinjury situation (5, range 2-10). Mean MOCART score was 43.2 ± 16.1. Although the cartilage layer had good integration, it showed high heterogeneity and no filling of the subchondral bone layer.
TruFit® failed to restore the normal MRI aspect of the subchondral bone and lamina in most cases. The appearance of the chondral layer in MRI was partially re-established. This unfavourable MRI appearance did not adversely influence the patient's outcome in the short time and they restored their previous level of activity. There was an inverse linear relationship between the size of the lesion and the functional scores.
Therapeutic case series; level 4.
使用合成支架治疗膝关节骨软骨损伤似乎是一种良好的手术选择，可避免供区发病。TruFit® 塞经常被证明不能很好地融合。
评估接受 TruFit® 治疗的膝关节骨软骨损伤患者的 MRI 表现与功能评分之间的关系。
采用 MOCART 评分对患者进行磁共振成像评估修复组织。使用 KOOS、SF-36 和 VAS 进行临床评估。还分析了治疗的软骨缺损大小与功能评分之间的相关性。
纳入 57 例患者，中位随访时间为 44.8 个月（范围 24 - 73 个月）。在最后一次随访时，KOOS、SF-36 和 VAS 评分从平均 58.5、53.9 和 8.5 分提高到平均 87.4、86.6 和 1.2 分（p<0.001）。较大的损伤在 KOOS（p = 0.04）和 SF-36（p = 0.029）方面改善较小。中位 Tegner 值恢复到受伤前水平（5，范围 2 - 10）。平均 MOCART 评分为 43.2 ± 16.1。虽然软骨层融合良好，但显示出高度异质性，软骨下骨层未填充。
在大多数情况下，TruFit® 未能恢复软骨下骨和板层的正常 MRI 表现。MRI 中软骨层的外观部分得以重建。这种不利的 MRI 表现并未在短时间内对患者的预后产生不利影响，他们恢复了之前的活动水平。损伤大小与功能评分之间存在负线性关系。
治疗性病例系列；4 级。
