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基于外侧股骨髁的同种异体骨软骨移植的表面匹配治疗内侧股骨髁病变:计算机模拟模型研究。

Topographic Matching of Osteochondral Allograft Transplantation Using Lateral Femoral Condyle for the Treatment of Medial Femoral Condyle Lesions: A Computer-Simulated Model Study.

机构信息

Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.

Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.

出版信息

Arthroscopy. 2018 Nov;34(11):3033-3042. doi: 10.1016/j.arthro.2018.05.039.

Abstract

PURPOSE

The purpose of this study was to determine whether lateral femoral condyle (LFC) osteochondral allografts (OCAs) would have a similar articular cartilage contour and resulting subchondral bone contour when compared with medial femoral condyle (MFC) allografts for the treatment of MFC chondral defects.

METHODS

In this controlled laboratory study, human femoral hemi-condyles (10 MFCs and 8 LFCs) were divided into 4 groups: MFC recipient, MFC donor, ipsilateral LFC donor, and contralateral LFC donor. Computed tomography (CT) images were obtained for each, and 3D CT models were created and exported into point-cloud models. Three circular defect and graft models were created on each condyle at 3 locations (0°, 45° posterior, and 90° posterior regions). The graft model in each donor group was virtually placed on the MFC recipient defect model. The least distances of the articular cartilage surface between the graft and the defect models and the resulting mean least distance of the subchondral bone surface were calculated.

RESULTS

The mean least distance of the articular cartilage surface was less than 0.5 mm in all donor-recipients, and there was no significant difference among donor groups. Although the mean least distance of the subchondral bone surface was significantly greater than the articular cartilage surface in all donor groups (P < .001), there was no significant difference among donor groups.

CONCLUSION

Ipsilateral and contralateral LFC grafts provided similar articular cartilage surface and resulting subchondral bone surface matching with that of MFC grafts, suggesting that LFCs could be a potential source of OCA for the treatment of MFC lesions.

CLINICAL RELEVANCE

Ipsilateral and contralateral LFCs can be suitable donor sites for the treatment of MFC lesions with OCAs.

摘要

目的

本研究旨在确定外侧股骨髁(LFC)同种异体骨软骨移植物(OCA)在治疗股骨内侧髁(MFC)软骨缺损时,与 MFC 同种异体移植物相比,其关节软骨轮廓和由此产生的软骨下骨轮廓是否相似。

方法

在这项对照性实验室研究中,将 10 个 MFC 和 8 个 LFC 人股骨半髁分为 4 组:MFC 受者、MFC 供者、同侧 LFC 供者和对侧 LFC 供者。对每个膝关节进行计算机断层扫描(CT)成像,并创建 3D CT 模型并导出为点云模型。在每个髁的 3 个位置(0°、45°后和 90°后区域)创建 3 个圆形缺损和移植物模型。在每个供者组的供体模型上虚拟放置 MFC 受者缺损模型。计算移植物和缺损模型之间关节软骨表面的最小距离以及由此产生的软骨下骨表面的平均最小距离。

结果

所有供者-受者的关节软骨表面最小距离均小于 0.5mm,且供者组之间无显著差异。虽然所有供者组的软骨下骨表面的平均最小距离均显著大于关节软骨表面(P <.001),但供者组之间无显著差异。

结论

同侧和对侧 LFC 移植物提供了与 MFC 移植物相似的关节软骨表面和由此产生的软骨下骨表面匹配,表明 LFC 可能是治疗 MFC 病变的 OCA 的潜在来源。

临床相关性

同侧和对侧 LFC 可作为治疗 MFC 病变的 OCAs 的合适供体部位。

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