Jones Kristofer J, Mosich Gina M, Williams Riley J
Department of Orthopaedic Surgery, Division of Sports Medicine and Shoulder Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
Arthrosc Tech. 2018 Jul 2;7(8):e791-e795. doi: 10.1016/j.eats.2018.03.016. eCollection 2018 Aug.
Fresh osteochondral allograft (OCA) transplantation is a successful single-stage procedure for the treatment of symptomatic cartilage defects of the knee. Although long-term studies reveal reliable improvements in patient-reported outcome scores and graft survival, the limitations of the procedure include graft availability and timely use prior to expiration. To avoid prolonged surgical wait times and progression of lesion size, some surgeons have employed the use of nonorthotopic grafts (e.g., lateral femoral condyle graft for a medial femoral condyle lesion). Additionally, fresh precut OCA cores can be used for smaller symptomatic lesions, thereby precluding surgical delays associated with donor-recipient size matching. We describe our preferred technique for the use of fresh precut OCA cores for the treatment of small osteochondral defects of the knee. The distinct advantages of this technique include single-stage restoration of the articular surface without the donor site morbidity observed with osteochondral autograft transplantation.
新鲜骨软骨异体移植（OCA）是治疗膝关节有症状软骨缺损的一种成功的单阶段手术。尽管长期研究显示患者报告的结局评分和移植物存活率有可靠改善，但该手术的局限性包括移植物的可获得性以及在过期前及时使用。为避免手术等待时间过长和病变大小进展，一些外科医生采用了非原位移植物（例如，用外侧股骨髁移植物治疗内侧股骨髁病变）。此外，新鲜预切割的OCA核心可用于较小的有症状病变，从而避免与供体 - 受体尺寸匹配相关的手术延迟。我们描述了我们使用新鲜预切割OCA核心治疗膝关节小骨软骨缺损的首选技术。该技术的独特优势包括关节面的单阶段修复，而不会出现自体骨软骨移植中观察到的供体部位并发症。
