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关节镜下清创及骨髓刺激治疗距骨骨软骨损伤后重返运动:一项5至24年的随访研究

Return to sports after arthroscopic debridement and bone marrow stimulation of osteochondral talar defects: a 5- to 24-year follow-up study.

作者信息

van Eekeren I C M, van Bergen C J A, Sierevelt I N, Reilingh M L, van Dijk C N

机构信息

Department of Orthopaedic Surgery, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.

Department of Orthopaedic Surgery, Slotervaart Ziekenhuis, Amsterdam, The Netherlands.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2016 Apr;24(4):1311-5. doi: 10.1007/s00167-016-3992-6. Epub 2016 Feb 4.

Abstract

PURPOSE

Osteochondral defects (OCD) often have a severe impact on the quality of life due to deep ankle pain during and after weight bearing, which prevents young patients from leading an active life. Arthroscopic debridement and bone marrow stimulation are currently the gold standard treatment. The purpose of this study was to evaluate the number of patients that resume and maintain sports to their pre-injury activity level after arthroscopic debridement and bone marrow stimulation.

METHODS

This retrospective study evaluated patients treated with arthroscopic debridement and bone marrow stimulation between 1989 and 2008. All patients who were participating in sports before injury were included. The Ankle Activity Scale (AAS) was used to determine activity levels during specific time points (before injury, before operation, after operation and at the time of final follow-up).

RESULTS

Ninety-three patients were included. Fifty-seven (76%) patients continued participating in sports at final follow-up. The median AAS before injury of 8 (range 3-10) significantly decreased to 4 (range 2-10) at final follow-up.

CONCLUSION

It is shown that 76% of the patients were able to return to sports at long-term follow-up after arthroscopic debridement and bone marrow stimulation of talar OCDs. The activity level decreased at long-term follow-up and never reached the level of that before injury. The data of our study can be of importance to inform future patients on expectations after debridement and bone marrow stimulation of a talar OCD.

LEVEL OF EVIDENCE

Retrospective case series, Level IV.

摘要

目的

骨软骨损伤(OCD)常常因负重期间及之后的深部踝关节疼痛而对生活质量产生严重影响,这使得年轻患者无法过上积极的生活。关节镜下清创术和骨髓刺激术目前是金标准治疗方法。本研究的目的是评估在接受关节镜下清创术和骨髓刺激术后恢复并维持运动至伤前活动水平的患者数量。

方法

这项回顾性研究评估了1989年至2008年间接受关节镜下清创术和骨髓刺激术治疗的患者。纳入所有伤前参加体育运动的患者。采用踝关节活动量表(AAS)来确定特定时间点(伤前、术前、术后及末次随访时)的活动水平。

结果

共纳入93例患者。57例(76%)患者在末次随访时继续参加体育运动。伤前AAS中位数为8(范围3 - 10),在末次随访时显著降至4(范围2 - 10)。

结论

结果显示,距骨OCDs患者在接受关节镜下清创术和骨髓刺激术后,76%的患者在长期随访时能够恢复运动。长期随访时活动水平下降,且从未达到伤前水平。我们的研究数据对于告知未来患者距骨OCD清创术和骨髓刺激术后的预期情况可能具有重要意义。

证据水平

回顾性病例系列,IV级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2553/4823315/2fc07107f7c6/167_2016_3992_Fig1_HTML.jpg

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