Cartilage Restoration Center, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
Cartilage Restoration Center, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A..
Arthroscopy. 2017 Sep;33(9):1712-1717. doi: 10.1016/j.arthro.2017.03.020.
To investigate functional outcomes among competitive athletes undergoing osteochondral allograft (OCA) transplantation of the knee, including rates of return to play (RTP), and factors preventing RTP.
A retrospective review identified all competitive athletes (high school, intercollegiate, professional) undergoing isolated femoral condyle OCA from 2004 to 2013. Patient-reported outcome (PRO) questionnaires (Lysholm, International Knee Documentation Committee [IKDC], Knee Injury and Osteoarthritis Outcome Score [KOOS], Western Ontario and McMasters Universities Arthritis Index [WOMAC], 12-Item Short Form Health Survey [SF-12], Tegner, and Marx) and custom RTP surveys were administered. All subsequent reoperations were documented.
Thirteen athletes (4 intercollegiate, 9 high-school) were identified with an average follow-up of 5.9 ± 2.5 years. Seven athletes (54%) returned to competitive sport at an average of 7.9 ± 3.5 months, 5 of whom returned to preinjury functional levels. Of the 8 athletes who either did not return to competitive sport or failed to sustain their high level of play, the most common reasons cited were graduation from high school or college (4 patients, 50%) or fear of reinjury (3 patients, 38%). All 4 patients citing graduation as the primary factor preventing return to preinjury level of competitive sport resumed recreational sport without limitations, yielding an adjusted RTP rate of 10 patients (77%) who either returned to competitive play or believed they could return if they had not graduated. At final follow-up, athletes reported significant improvements in all PRO scores except for KOOS-Sport, WOMAC-Stiffness, and SF-12 Mental subscales. There were 3 reoperations at an average of 3.8 ± 3.3 years after the index OCA. There were no instances of graft failure.
OCAs provide an adjusted RTP rate of 77% for high-level adolescent athletes. Social factors may be more likely than persistent pain to prevent return to sport.
Level IV, therapeutic case series.
研究行膝关节骨软骨同种异体移植（OCA）的竞技运动员的功能结果，包括重返赛场（RTP）率以及阻止 RTP 的因素。
回顾性分析 2004 年至 2013 年间接受单纯股骨髁 OCA 的竞技运动员（高中生、大学生、职业运动员）。进行患者报告的结局（PRO）问卷（Lysholm、国际膝关节文献委员会 [IKDC]、膝关节损伤和骨关节炎结果评分 [KOOS]、西安大略和麦克马斯特大学关节炎指数 [WOMAC]、12 项简明健康调查 [SF-12]、Tegner 和 Marx）和定制 RTP 调查。记录所有后续再次手术的情况。
确定了 13 名运动员（4 名大学生、9 名高中生），平均随访 5.9±2.5 年。7 名运动员（54%）平均在 7.9±3.5 个月后重返竞技运动，其中 5 名运动员恢复到受伤前的功能水平。在 8 名未重返竞技运动或无法维持高运动水平的运动员中，最常见的原因是高中毕业或大学毕业（4 名患者，50%）或害怕再次受伤（3 名患者，38%）。所有 4 名因毕业而无法重返伤前竞技运动水平的患者均恢复了无限制的娱乐性运动，调整后的 RTP 率为 10 名患者（77%），他们要么重返竞技运动，要么认为如果没有毕业他们可以重返竞技运动。在最终随访时，运动员报告除 KOOS-Sport、WOMAC-Stiffness 和 SF-12 心理分量表外，所有 PRO 评分均显著改善。在接受 OCA 指数治疗后平均 3.8±3.3 年进行了 3 次再次手术。没有移植物失败的情况。
OCA 为高水平青少年运动员提供了 77%的调整后 RTP 率。社会因素可能比持续疼痛更有可能阻止运动员重返赛场。
IV 级，治疗性病例系列。
