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股骨远端髁关节软骨表面的地形分析:同种或不同大小对侧髁骨移植物用于骨软骨移植的合适性。

Topographic Analysis of the Distal Femoral Condyle Articular Cartilage Surface: Adequacy of the Graft from Opposite Condyles of the Same or Different Size for the Osteochondral Allograft Transplantation.

机构信息

1 Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.

2 Mayo Clinic, Rochester, MN, USA.

出版信息

Cartilage. 2019 Apr;10(2):205-213. doi: 10.1177/1947603517752056. Epub 2018 Jan 16.

DOI:10.1177/1947603517752056
PMID:29334769
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6425537/
Abstract

OBJECTIVE

To analyze the topography of the opposite condyle to treat focal femoral condyle articular defects with an osteochondral allograft (OCA).

DESIGN

Three groups were created: Group 1, same condyle with same width; Group 2, opposite condyle with same width; Group 3, opposite condyle with different width. Computed tomography (CT) of 22 cadaveric femoral hemi-condyles was used to create 3-dimensional CT models that were exported into point-cloud models. Three zones of the donor condyle (anterior, middle, and posterior) were quantified. Four defect sizes were created (15, 18, 23, 25 mm) at the weight-bearing region. The defect was moved throughout each donor condyle zone and the least distance was calculated, defined as the shortest distance between the defect and the donor condyle.

RESULTS

The mean least distance increased with larger defect size in all groups, yet there was a less than 0.2 mm difference in the least distance among defect sizes. The 15, 18, and 23 mm defect models in Group 1 exhibited greater least distances at the anterior than middle and posterior zones. The 15 mm defect model exhibited greater least distance at the anterior zone than posterior zone in Group 3. However, there was a less than 0.05 mm difference in the mean least distance between zones. There was no significant difference in the least distance between groups.

CONCLUSION

OCAs from opposite condyles yield similar topographic matching to OCAs from the same condyles, suggesting that opposite condyles can be utilized. Clinical correlation and outcomes are necessary.

摘要

目的

分析对侧髁的解剖学特征,用同种异体骨软骨移植(OCA)治疗局限性股骨髁关节面缺损。

设计

创建了三组:组 1,同髁同宽;组 2,对侧髁同宽;组 3,对侧髁不同宽。使用 22 个尸体股骨半髁的计算机断层扫描(CT)创建三维 CT 模型,并将其导出为点云模型。对供体髁的三个区域(前、中、后)进行了量化。在承重区创建了四个缺损尺寸(15、18、23、25mm)。将缺损移动到每个供体髁区域,并计算最小距离,定义为缺损与供体髁之间的最短距离。

结果

在所有组中,随着缺损尺寸的增大,平均最小距离均增加,但缺损尺寸之间的最小距离差异小于 0.2mm。组 1 中 15、18 和 23mm 缺损模型在前区的最小距离大于中区和后区。在组 3 中,15mm 缺损模型在前区的最小距离大于后区。然而,各区域之间的最小距离差异小于 0.05mm。组间最小距离无显著差异。

结论

来自对侧髁的 OCA 与来自同侧髁的 OCA 具有相似的地形匹配,提示可以使用对侧髁。需要进行临床相关性和结果分析。

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本文引用的文献

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J Bone Joint Surg Am. 2017 Oct 4;99(19):1614-1620. doi: 10.2106/JBJS.16.01542.
2
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Am J Sports Med. 2017 Feb;45(2):403-409. doi: 10.1177/0363546516671519. Epub 2016 Oct 29.
3
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Arthroscopy. 2015 May;31(5):843-9. doi: 10.1016/j.arthro.2014.11.039. Epub 2015 Jan 28.
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10
Osteochondral grafting: effect of graft alignment, material properties, and articular geometry.骨软骨移植:移植物排列、材料特性及关节几何形状的影响
Open Orthop J. 2009 Aug 6;3:61-8. doi: 10.2174/1874325000903010061.