Dasar U, Gursoy S, Akkaya M, Algin O, Isik C, Bozkurt M
Department of Orthopedics and Traumatology, Karabuk Training and Research Hospital, Karabuk, Turkey.
Department of Orthopedics and Traumatology, Yenimahalle Training and Research Hospital, Ankara, Turkey.
J Orthop Surg (Hong Kong). 2016 Aug;24(2):188-93. doi: 10.1177/1602400214.
To compare the microfracture technique with carbon fibre rod implantation for treatment of knee articular cartilage lesions.
10 men and 30 women aged 22 to 56 (mean, 37.4) years underwent microfracture (n=20) or carbon fibre rod implantation (n=20) for International Cartilage Repair Society grade 3 to 4 knee articular cartilage lesions after a mean of 12.2 months of viscosupplementation and physiotherapy. Clinical outcome at 6 and 12 months was assessed using the Tegner-Lysholm score and modified Cincinnati score. Magnetic resonance imaging (MRI) outcome at 12 months was assessed by a radiologist. The modified magnetic resonance observation of cartilage repair tissue (MOCART) score was evaluated.
The 2 groups were comparable in terms of age, body mass index, lesion location, lesion size, duration of symptoms, and coexisting pathology. The microfracture group had a higher preoperative Tegner-Lysholm score (39.4±7.3 vs. 34.4±4.9, p=0.015) and modified Cincinnati score (36.4±7.2 vs. 30.4±4.0, p=0.002) than the carbon fibre rod group. At 12 months, change in both scores was significant within each group (p<0.001) and was higher in the microfracture than carbon fibre rod group (p<0.001). MRI showed minimal regenerative tissue. Lobulation, oedema, and hypertrophy were more commonly found in the regeneration tissue after carbon fibre rod implantation than microfracture. At 12 months, the MOCART score was higher in the microfracture than carbon fibre rod group (59 vs. 47, p<0.001).
Microfracture is superior to carbon fibre rod implantation in terms of clinical and radiological outcome.
比较微骨折技术与碳纤维棒植入术治疗膝关节软骨损伤的效果。
10名男性和30名女性，年龄在22至56岁（平均37.4岁），在平均12.2个月的关节腔内注射透明质酸钠和物理治疗后，因国际软骨修复协会3至4级膝关节软骨损伤接受了微骨折治疗（n = 20）或碳纤维棒植入治疗（n = 20）。使用Tegner-Lysholm评分和改良的辛辛那提评分评估6个月和12个月时的临床结果。由放射科医生评估12个月时的磁共振成像（MRI）结果。评估改良的软骨修复组织磁共振观察（MOCART）评分。
两组在年龄、体重指数、损伤部位、损伤大小、症状持续时间和并存疾病方面具有可比性。微骨折组术前Tegner-Lysholm评分（39.4±7.3对34.4±4.9，p = 0.015）和改良的辛辛那提评分（36.4±7.2对30.4±4.0，p = 0.002）高于碳纤维棒组。在12个月时，每组内两个评分的变化均有统计学意义（p<0.001），且微骨折组高于碳纤维棒组（p<0.001）。MRI显示再生组织极少。与微骨折相比，碳纤维棒植入后再生组织中更常见分叶、水肿和肥大。在12个月时，微骨折组的MOCART评分高于碳纤维棒组（59对47，p<0.001）。
在临床和影像学结果方面，微骨折优于碳纤维棒植入术。
