Department of Orthopaedic Surgery, Kaiser Permanente Southern California, Baldwin Park, CA, USA.
Department of Orthopaedic Surgery, USC Keck School of Medicine, Los Angeles, CA, USA.
Cartilage. 2020 Oct;11(4):431-440. doi: 10.1177/1947603518796124. Epub 2018 Sep 3.
To evaluate clinical, functional, and radiographic outcomes of patients who underwent bipolar osteochondral allograft transplantation (OCAT) of the patellofemoral joint (PFJ).
Prospectively collected data on 18 knees who underwent fresh osteochondral allograft transplantation of the patella and trochlea by a single surgeon were reviewed. Inclusion criteria were: high-grade chondral lesions of PFJ (5 knees), or recurrent patella dislocations with trochlear dysplasia and chondral injury to the patella and/or trochlea (13 knees). Functional scores were obtained preoperatively and at follow-up appointments included Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), Oxford, Cincinnati, Tenger-Lysholm, visual analogue scale (VAS)-pain, and Single Assessment Numeric Evaluation (SANE). Grafts were also evaluated using Osteochondral Allograft MRI Scoring System (OCAMRISS).
Three patients were lost to follow-up, leaving 4 knees in group 1, and 11 knees in group 2. Average age was 28.9 years (range 16-52 years). The average follow-up was 33.2 months (range 12-64 months). There was significant improvement of KOOS (from 38.7 to 83.1), IKDC (from 28.2 to 76.6), Tegner-Lysholm (from 38.3 to 88.3), Oxford (from 22.7 to 42.9), Cincinnati (from 35.1 to 83.6), VAS (from 71 to 17.9.), and SANE (from 43.3 to 83) ( < 0.0001). The OCAMRISS score for patella was 2.23 and for trochlea 4.69. There were no revisions or conversions to arthroplasty.
Bipolar OCAT of the patella and trochlea provide significant improvement in functional outcomes, relief from pain, activity level, and prevent recurrent instability.
评估接受髌股关节（PFJ）双极骨软骨同种异体移植（OCAT）的患者的临床、功能和影像学结果。
回顾了一位外科医生对 18 例膝关节进行新鲜骨软骨同种异体移植的前瞻性收集数据。纳入标准为：PFJ 高等级软骨损伤（5 例），或复发性髌骨脱位伴滑车发育不良和髌骨及/或滑车软骨损伤（13 例）。术前及随访时获得膝关节损伤和骨关节炎结果评分（KOOS）、国际膝关节文献委员会（IKDC）、牛津、辛辛那提、滕格尔-莱什霍姆、视觉模拟评分（VAS）-疼痛和单因素评估数字评估（SANE）。还使用骨软骨同种异体移植 MRI 评分系统（OCAMRISS）评估移植物。
3 例患者失访，1 组 4 例，2 组 11 例。平均年龄 28.9 岁（16-52 岁）。平均随访时间为 33.2 个月（12-64 个月）。KOOS（从 38.7 提高到 83.1）、IKDC（从 28.2 提高到 76.6）、Tegner-Lysholm（从 38.3 提高到 88.3）、牛津（从 22.7 提高到 42.9）、辛辛那提（从 35.1 提高到 83.6）、VAS（从 71 提高到 17.9）和 SANE（从 43.3 提高到 83）均有显著改善（<0.0001）。髌骨的 OCAMRISS 评分为 2.23，滑车的评分为 4.69。无翻修或关节置换。
髌股关节的双极 OCAT 可显著改善功能结果，缓解疼痛、活动水平，并预防复发性不稳定。
