Department of Orthopedics and Traumatology, Ankara City Hospital, 06000, Ankara, Turkey.
Department of Orthopedics and Traumatology, İzmir Atatürk Research and Training Hospital, Izmir, Turkey.
Arch Orthop Trauma Surg. 2020 Feb;140(2):209-218. doi: 10.1007/s00402-019-03305-5. Epub 2019 Nov 20.
The goal of this study was to share our experience with two different inlay metallic implants in the treatment of knee cartilage defects and to analyze their effects on functional scores.
This retrospective study included 118 patients operated on for focal full-thickness knee cartilage lesions, who were treated with a focal metallic inlay resurfacing prosthesis. A cobalt-chromium (Co-Cr) resurfacing implant was applied to 73 patients with a knee chondral lesion, and a biosynthetic implant was applied to 45. All patients were evaluated preoperatively and postoperatively using the KOOS, VAS, and Tegner activity scores.
The group with the Co-Cr-resurfacing implant showed a significantly greater improvement (p < 0.001) in the Tegner and VAS scores at the 2-year follow-up examination. The KOOS scores were similar in both groups. Median patient age was similar in both groups. All patients had a follow-up of at least 2 years. The preoperative and postoperative scores were compared and significant improvements (p < 0.001) were observed. The biosynthetic implant had a higher revision rate. In the univariate analysis, age and type of implant were significantly associated with revision surgery. In the multivariate Cox-regression analysis model, the type of implant was significantly associated with revision surgery.
All the patients operated with the above-mentioned implants showed significant improvements in pain and activity scores. Despite the overall good clinical results, 17% of patients with a biosynthetic implant and > 6% of patients with Co-Cr-resurfacing implant required revision surgery. Age and implant type were the main risk factors associated with revision.
本研究旨在分享我们使用两种不同的嵌体金属植入物治疗膝关节软骨缺损的经验，并分析其对功能评分的影响。
这是一项回顾性研究，纳入了 118 名因膝关节软骨全层病变而接受局灶性金属嵌体覆盖假体治疗的患者。73 例膝关节软骨病变患者应用钴铬（Co-Cr）表面置换假体，45 例应用生物合成假体。所有患者术前及术后均采用 KOOS、VAS 和 Tegner 活动评分进行评估。
Co-Cr 表面置换组在 2 年随访时的 Tegner 和 VAS 评分改善更明显（p < 0.001）。两组的 KOOS 评分相似。两组患者的中位年龄相似。所有患者的随访时间均至少为 2 年。比较术前和术后评分，均有显著改善（p < 0.001）。生物合成假体的翻修率较高。单因素分析显示，年龄和植入物类型与翻修手术显著相关。在多因素 Cox 回归分析模型中，植入物类型与翻修手术显著相关。
所有接受上述植入物治疗的患者疼痛和活动评分均有显著改善。尽管总体临床效果良好，但 17%的生物合成假体患者和>6%的 Co-Cr 表面置换假体患者需要进行翻修手术。年龄和植入物类型是与翻修相关的主要危险因素。
