Centro Hospitalar de Lisboa Ocidental, EPE. Estrada do Forte do Alto do Duque, 1449-005, Lisbon, Portugal.
Knee Surg Sports Traumatol Arthrosc. 2019 Jan;27(1):245-250. doi: 10.1007/s00167-018-5085-1. Epub 2018 Aug 1.
The aim of this study was to prospectively evaluate donor site morbidity in arthroscopic superior capsular reconstruction using a minimally invasive harvested fascia lata autograft.
Fifteen consecutive patients underwent arthroscopic superior capsular reconstruction by the senior author using a fascia lata autograft harvested in a minimally invasive fashion. All patients were prospectively evaluated at 1 week, 6 and 18 months postoperatively. The subjects' body mass index, age, actual or previous corticosteroid therapy history and active smoking habits were evaluated. Functional outcomes were assessed by the non-arthritic hip score applied to the harvested and contralateral thighs. Every patient completed standardized subjective satisfaction questionnaires at all evaluations. The median patient age was 65.5 years (range 47-77). Nine patients (60%) were females, and six (40%) were males. One patient (6.7%) was within the normal range of weight, nine (60%) were overweight, four (27%) were obese, and one (6.7%) was extremely obese. Two patients (13%) were active smokers. No patients had an active or previous record of corticosteroid therapy. No patients required postoperative lower limb physical therapy.
In terms of overall and cosmetic satisfaction, most patients reported that they were satisfied or very satisfied at all evaluations, and the proportion of very satisfied patients increased over time (p < 0.001). The harvested thigh's functional scores were 91% (p = 0.003) and 94% (p = 0.008) of the healthy thigh's score at 6 and 18 months, respectively. The complications reported were mild, and their proportions decreased in the first 18 months after surgery (p = 0.04).
The minimally invasive fascia lata harvesting technique for arthroscopic superior capsular reconstruction leads to donor site satisfactory subjective results and good functional outcomes at 18 months after surgery. According to these findings, donor site morbidity is not a valid argument against the use of this autograft for arthroscopic superior capsular reconstruction.
Case series, level IV.
本研究旨在前瞻性评估使用微创切取阔筋膜移植物进行关节镜上囊重建的供区发病率。
15 例连续患者由资深作者使用微创切取阔筋膜移植物进行关节镜上囊重建。所有患者均在术后 1 周、6 个月和 18 个月进行前瞻性评估。评估患者的体重指数、年龄、实际或既往皮质类固醇治疗史和主动吸烟习惯。通过非关节炎髋关节评分对供区和对侧大腿进行功能评估。每位患者在所有评估中均完成标准化的主观满意度问卷。中位患者年龄为 65.5 岁（范围 47-77 岁）。9 例（60%）为女性，6 例（40%）为男性。1 例（6.7%）为正常体重，9 例（60%）为超重，4 例（27%）为肥胖，1 例（6.7%）为极度肥胖。2 例（13%）为主动吸烟者。无患者有活动或既往皮质类固醇治疗史。无患者术后需要下肢物理治疗。
在整体和美容满意度方面，大多数患者在所有评估中报告满意或非常满意，且非常满意患者的比例随时间增加（p<0.001）。术后 6 个月和 18 个月，供区大腿的功能评分分别为健侧大腿的 91%（p=0.003）和 94%（p=0.008）。报告的并发症轻微，且在术后 18 个月内比例下降（p=0.04）。
微创切取阔筋膜移植物进行关节镜上囊重建，术后 18 个月可获得供区满意的主观结果和良好的功能结果。根据这些发现，供区发病率并不是反对使用这种自体移植物进行关节镜上囊重建的有效论据。
病例系列，IV 级。
