Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA.
Cartilage. 2021 Dec;13(1_suppl):1014S-1021S. doi: 10.1177/1947603520903420. Epub 2020 Feb 10.
To analyze the clinical outcomes, knee function, and activity level of patients after treatment of full-thickness cartilage defects involving the patellofemoral compartment of the knee with cryopreserved osteochondral allograft.
Nineteen patients with cartilage defects involving the patellofemoral compartment were treated. The average age was 31 years (range 15-45 years), including 12 females and 7 males. Patients were prospectively followed using validated clinical outcome measures including Veterans RAND 12-item Health Survey (VR-12), International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Tegner activity scale. Graft incorporation was evaluated by magnetic resonance imaging (MRI) or second-look arthroscopy.
The cartilage defects included the patella ( = 16) and the femoral trochlea ( = 3). Mean VR-12 scores increased from 31.6 to 46.3 ( < 0.01), mean IKDC increased from 40.0 to 69.7 ( < 0.01), mean KOOS increased from 53.9 to 80.2 ( < 0.01), and mean Tegner scores increased from 3.0 to 4.9 ( < 0.01), at average follow-up of 41.9 months (range 24-62 months). Of the 3 patients who underwent second-look arthroscopy, all demonstrated a well-incorporated graft. Mean MOCART score for the 6 patients with follow-up MRI was 62.5 (range 25-85). The reoperation rate was 21.1% and 2 patients (12.5%) experienced progressive patellofemoral osteoarthritis requiring conversion to patellofemoral arthroplasty.
Patients with unipolar cartilage defects involving the patellofemoral compartment of the knee can have positive outcomes at minimum 2-year follow-up after surgical treatment with a cryopreserved osteochondral allograft when concomitant pathology is also addressed, but the reoperation rate is high and bipolar cartilage lesions may increase the failure rate.
分析全层软骨缺损患者的临床结果、膝关节功能和活动水平，这些患者接受了冷冻保存的异体骨软骨移植治疗膝关节髌股关节的软骨缺损。
19 例髌股关节软骨缺损患者接受了治疗。平均年龄 31 岁（15-45 岁），包括 12 名女性和 7 名男性。采用经过验证的临床结果评估方法，包括退伍军人 RAND 12 项健康调查（VR-12）、国际膝关节文献委员会（IKDC）、膝关节损伤和骨关节炎结果评分（KOOS）和 Tegner 活动量表，对患者进行前瞻性随访。通过磁共振成像（MRI）或二次关节镜检查评估移植物的整合情况。
软骨缺损包括髌骨（=16）和股骨滑车（=3）。平均 VR-12 评分从 31.6 增加到 46.3（<0.01），平均 IKDC 从 40.0 增加到 69.7（<0.01），平均 KOOS 从 53.9 增加到 80.2（<0.01），平均 Tegner 评分从 3.0 增加到 4.9（<0.01），平均随访时间为 41.9 个月（24-62 个月）。在接受二次关节镜检查的 3 例患者中，所有患者的移植物均得到了很好的整合。6 例接受 MRI 随访的患者的平均 MOCART 评分分别为 62.5（25-85）。再次手术率为 21.1%，2 例（12.5%）患者出现进行性髌股关节炎，需要转为髌股关节置换。
当同时解决伴随的病理问题时，接受冷冻保存的异体骨软骨移植治疗膝关节髌股关节单髁软骨缺损的患者在至少 2 年的随访后可以获得积极的结果，但再次手术率较高，双髁软骨病变可能会增加失败率。
