Solheim Eirik, Hegna Janne, Inderhaug Eivind
Department of Orthopedics, Deaconess University Hospital, Haraldsplass, Bergen, Norway; Department of Orthopedics, Aleris Nesttun Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
Department of Orthopedics, Aleris Nesttun Hospital, Bergen, Norway.
Knee. 2017 Dec;24(6):1402-1407. doi: 10.1016/j.knee.2017.08.061. Epub 2017 Sep 27.
The purpose of this study was to evaluate the outcome after cartilage repair surgery in focal defects of the knee by microfracture versus mosaicplasty.
A cohort of 102 patients undergoing microfracture (n=52) or mosaicplasty (n=50) of a single articular cartilage defect in the medial femoral condyle of ≤50mm was evaluated by Lysholm score before surgery, at six months, 12months, five years, 10years, and 15-18years after surgery.
Median age of patients at the time of surgery was 36years (range 16-58) and median follow-up time was 16years (range 14-18). Defects were treated with a median size of three square centimetres (range one to five). A significant increase was seen in the Lysholm score from mean 48 (SD 16) at baseline to 66 (SD 23; P<0.001) at the 15-18year follow-up. The Lysholm score was higher in the mosaicplasty group at six months, 12months, five years and 10years (P<0.05 for all comparisons). These differences were clinically significant at all points (>10 points). However, at the final follow-up, the difference (eight points) did not reach statistical significance.
In the short-term, medium-term and long-term (10years), mosaicplasty in a single cartilage defect size one to five square centimetres of the femoral condyle resulted in clinically relevant better outcome than microfracture. However, at 15-18years after the surgery such a difference could not be found. In the six month to 10-15year (after surgery) perspective, the mosaicplasty procedure offered a better outcome in this type of lesion.
Level III.
本研究的目的是评估微骨折术与镶嵌植骨术治疗膝关节局灶性软骨缺损修复手术后的效果。
对102例接受微骨折术（n = 52）或镶嵌植骨术（n = 50）治疗内侧股骨髁单个关节软骨缺损且缺损面积≤50平方毫米的患者，在术前、术后6个月、12个月、5年、10年以及15 - 18年通过Lysholm评分进行评估。
患者手术时的中位年龄为36岁（范围16 - 58岁），中位随访时间为16年（范围14 - 18年）。缺损的中位面积为3平方厘米（范围1 - 5平方厘米）。Lysholm评分从基线时的平均48分（标准差16）显著提高到15 - 18年随访时的66分（标准差23；P < 0.001）。在术后6个月、12个月、5年和10年时，镶嵌植骨术组的Lysholm评分更高（所有比较P < 0.05）。这些差异在所有时间点均具有临床显著性（> 10分）。然而，在最终随访时，差异（8分）未达到统计学显著性。
在短期、中期和长期（10年），对于股骨髁面积为1至5平方厘米的单个软骨缺损，镶嵌植骨术在临床上的效果优于微骨折术。然而，在术后15 - 18年未发现这种差异。从术后6个月至10 - 15年的角度来看，镶嵌植骨术在这类损伤中效果更好。
三级。
