Department of Orthopedic Surgery, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Republic of Korea.
Department of Radiology, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Republic of Korea.
Knee Surg Sports Traumatol Arthrosc. 2018 Jul;26(7):2123-2130. doi: 10.1007/s00167-017-4610-y. Epub 2017 Jun 17.
Little is known about the arthroscopic or radiographic outcomes after arthroscopic microfracture of osteochondral lesions of the talus (OLTs). The purpose of this study was to investigate tissue growth after arthroscopic microfracture of OLTs using computed tomography arthrography (CTA) and to identify the relationship between CTA findings and clinical outcomes. We hypothesized that the morphology of the repaired tissue would be similar to that of normal anatomy and correlate with the clinical outcomes.
Forty-two ankles treated using arthroscopic microfracture of OLTs between 2009 and 2014 were monitored. CTA was performed post-operatively at 6 months and at 1 and 2 years after surgery. The post-operative thickness of the repaired tissue associated with OLT (grade) and the volume of the subchondral cystic lesions were evaluated using CTA. Clinical outcomes, including the pain visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle functional scores, were evaluated and correlated with CTA.
The proportion of fully grown tissue (grade 3) increased over time; specifically, the rates were 12/40 (33.3%) at 6 months, 11/18 (61.1%) at 1 year, and 8/10 (80%) at 2 years after surgery (p = 0.005). The VAS pain (p < 0.001) and AOFAS scores (p < 0.001) were also improved at the final follow-up; however, they were not associated with repaired tissue thickness as shown by CTA (n.s.).
After microfracture of OLTs, tissue growth in the osteochondral defects was well visualized using CT arthrography and was observed in most cases. However, the CTA findings were not related to the clinical outcomes.
IV.
对于距骨骨软骨损伤（OLTs）的关节镜下微骨折术，人们对其关节镜或影像学结果知之甚少。本研究旨在通过关节镜计算机断层扫描造影术（CTA）来研究 OLT 关节镜下微骨折术后的组织生长情况，并确定 CTA 结果与临床结果之间的关系。我们假设修复组织的形态将与正常解剖相似，并与临床结果相关。
2009 年至 2014 年间，我们对 42 例接受 OLT 关节镜下微骨折术的踝关节进行了监测。术后 6 个月、1 年和 2 年分别进行 CTA 检查。使用 CTA 评估与 OLT 相关的修复组织的术后厚度（分级）和软骨下囊性病变的体积。评估了临床结果，包括疼痛视觉模拟量表（VAS）和美国矫形足踝协会（AOFAS）踝关节功能评分，并与 CTA 相关联。
随着时间的推移，完全生长的组织（分级 3）的比例增加；具体而言，术后 6 个月的比例为 12/40（33.3%），术后 1 年为 11/18（61.1%），术后 2 年为 8/10（80%）（p=0.005）。最终随访时，VAS 疼痛（p<0.001）和 AOFAS 评分（p<0.001）也得到了改善；然而，它们与 CTA 所示的修复组织厚度无关（n.s.）。
在 OLT 微骨折术后，使用 CT 关节造影术可以很好地观察到骨软骨缺损处的组织生长，并且在大多数情况下都可以观察到。然而，CTA 结果与临床结果无关。
IV。
