Emre T Y, Atbasi Z, Demircioglu D T, Uzun M, Kose O
Department of Orthopedics and Traumatology, Memorial Hizmet Hospital, Halkalı Caddesi Yeşilköy Toplu Konut Sitesi A 31 Yeşilköy, Istanbul, Turkey.
Department of Orthopedics and Traumatology, Ankara Military Hospital, Ankara, Turkey.
Musculoskelet Surg. 2017 Aug;101(2):133-138. doi: 10.1007/s12306-016-0448-6. Epub 2016 Dec 31.
The purpose of this retrospective study was to evaluate the results of osteochondral autografting (mosaicplasty) in isolated articular cartilage defects of the patellofemoral joint.
Thirty-three patients who underwent mosaicplasty for patellofemoral (either patella or trochlea) cartilage defects (modified Outerbridge classification: grades III and IV) of the knee joint were retrospectively reviewed. There were 25 male and 8 female patients with a mean age of 31.3 ± 6.7 (range 22-47) years. The average size of the lesion was 2.4 ± 0.55 cm (range 1.5-4.0). Patients with patellofemoral malalignment were excluded. All patients were followed at least one year with a mean of 19.3 ± 4.3 months (range 12-24 months) using Lysholm knee score.
The mean preoperative Lysholm knee score was 51.9 ± 2.6 (47-58) points and increased to 85.5 ± 4.2 (75-89) points at the final follow-up. There was a significant increase in Lysholm score during follow-up period (p = 0.0001). The results were good in 24 cases and fair in 9 cases. No patients had poor results. No patients had infection. Five patients had postoperative mild painful hemarthrosis. Of these patients, four were treated with rest, ice, compression (elastic bandage) and elevation and the remaining one was treated by aspiration. No patients needed secondary open or arthroscopic drainage. No systemic complications occurred during the follow-up.
Mosaicplasty is an effective technique for the treatment of articular cartilage defects of the patellofemoral joint knee which restores the joint function in a short period of follow-up. However, a meticulous surgical technique should be followed to restore the native articular surface and the congruity of the joint.
本回顾性研究旨在评估自体骨软骨移植术（镶嵌成形术）治疗髌股关节孤立性关节软骨缺损的效果。
回顾性分析33例行镶嵌成形术治疗膝关节髌股（髌骨或滑车）软骨缺损（改良Outerbridge分级：III级和IV级）的患者。其中男性25例，女性8例，平均年龄31.3±6.7（22 - 47）岁。病变平均大小为2.4±0.55 cm（1.5 - 4.0 cm）。排除髌股关节排列不齐的患者。所有患者均采用Lysholm膝关节评分进行至少1年的随访，平均随访时间为19.3±4.3个月（12 - 24个月）。
术前Lysholm膝关节评分平均为51.9±2.6（47 - 58）分，末次随访时增至85.5±4.2（75 - 89）分。随访期间Lysholm评分显著升高（p = 0.0001）。结果为优24例，良9例。无患者结果为差。无患者发生感染。5例患者术后出现轻度创伤性关节积血。其中4例采用休息、冰敷、加压（弹力绷带）和抬高患肢治疗，其余1例采用穿刺抽吸治疗。无患者需要二次切开或关节镜引流。随访期间未发生全身并发症。
镶嵌成形术是治疗髌股关节膝关节软骨缺损的有效技术，可在短期内恢复关节功能。然而，应遵循精细的手术技术以恢复天然关节面和关节的一致性。
