Andrade Renato, Vasta Sebastiano, Papalia Rocco, Pereira Hélder, Oliveira J Miguel, Reis Rui L, Espregueira-Mendes João
Faculty of Sports, University of Porto, Porto, Portugal; Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal.
Orthopaedic and Trauma Department, Campus Biomedico University of Rome, Rome, Italy.
Arthroscopy. 2016 Jul;32(7):1466-77. doi: 10.1016/j.arthro.2016.01.055. Epub 2016 Apr 16.
To systematize the available scientific literature on the prevalence of articular cartilage and/or osteochondral lesions in football (soccer) players' knees, and overview the surgical procedures and functional outcomes and return to sports.
A comprehensive search using Pubmed, Cochrane Library, SPORTDiscus, and CINAHL databases was carried out until September 30, 2015. All English language studies that assessed the outcomes of a surgical technique for the treatment of articular cartilage lesions in football players' knees, with a minimum follow-up of 12 months, were included. The reference list of the most relevant papers was screened. The main outcomes of interest were the clinical, arthroscopy or imaging primary outcomes and the return to sports rate. The methodological and reporting qualities were assessed according to Coleman methodology score.
The search provided 485 titles and abstracts. Five studies were eligible for inclusion (mean Coleman score of 37.2 points), comprising a total of 183 football players with a mean age of 25.7 years. A total of 217 articular cartilage and/or osteochondral lesions were reported, where the medial and lateral femoral condyles were the most common sites of lesion. The surgical procedures investigated were mosaicplasty, microfracture, autologous chondrocyte implantation, and chondral debridement.
No definitive conclusion could be made in respect to the best current surgical technique for articular cartilage and osteochondral lesions. Microfracture and mosaicplasty can provide a faster return to competition and faster clinical and functional results, whereas autologous chondrocyte implantation and/or matrix-induced autologous chondrocytes implantation procedures can enhance longstanding clinical and functional results.
Level IV, systematic review of Level III and IV studies.
对有关足球（英式足球）运动员膝关节软骨和/或骨软骨损伤患病率的现有科学文献进行系统化整理，并概述手术程序、功能结果及恢复运动情况。
截至2015年9月30日，利用PubMed、Cochrane图书馆、SPORTDiscus和CINAHL数据库进行全面检索。纳入所有评估足球运动员膝关节软骨损伤手术技术结果的英文研究，最低随访时间为12个月。筛选最相关论文的参考文献列表。主要关注的结果是临床、关节镜检查或影像学主要结果以及恢复运动率。根据科尔曼方法评分评估方法学和报告质量。
检索得到485篇标题和摘要。五项研究符合纳入标准（科尔曼平均评分为37.2分），共纳入183名足球运动员，平均年龄25.7岁。共报告了217例关节软骨和/或骨软骨损伤，其中股骨内外侧髁是最常见的损伤部位。所研究的手术程序包括镶嵌成形术、微骨折术、自体软骨细胞植入术和软骨清创术。
关于目前治疗关节软骨和骨软骨损伤的最佳手术技术，无法得出明确结论。微骨折术和镶嵌成形术可使运动员更快恢复比赛，并能更快取得临床和功能结果，而自体软骨细胞植入术和/或基质诱导自体软骨细胞植入术可改善长期临床和功能结果。
四级，对三级和四级研究的系统评价。
