Tan Shijie Ian, Tho Samuel Jun Wei, Tho Kam San
Ministry of Health Holdings, Singapore.
Eastern Health, Victoria, Australia.
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(1):2309499020905158. doi: 10.1177/2309499020905158.
Hyalofast grafting with microfracture is a new minimally invasive treatment method being proposed for joint cartilage defects. This study was done to measure the clinical efficacy of Hyalofast grafting after microfractures.
Forty-six patients were assessed for knee function using knee injury and osteoarthritis outcome score (KOOS) after undergoing microfracture and Hyalofast grafting surgery. We further divided the 46 patients into a group of 10 patients who had no associated procedures done with the microfracture and Hyalofast grafting surgery. All patients had magnetic resonance imaging (MRI) of the affected knee pre-surgery and two patients had MRI done post-surgery. Due to another unrelated injury, we were also able to obtain further arthroscopic findings of another patient's knee 18 months after microfracture and Hyalofast grafting.
There was a statistically significant improvement in all categories of the KOOS (symptoms, pain, daily living, sports and quality of life) compared between years 1, 2 and 3 against pre-surgery. For the subgroup of Hyalofast only, there was a statistically significant improvement in symptoms, pain and daily living categories of the KOOS compared between years 1, 2 and 3 against pre-surgery.
Our study shows that Hyalofast grafting after microfracture is a viable alternative to treatment for patients with grade 4 cartilage ulcers.
透明质酸快速移植联合微骨折术是一种针对关节软骨缺损提出的新型微创治疗方法。本研究旨在测量微骨折术后透明质酸快速移植的临床疗效。
46例患者在接受微骨折术和透明质酸快速移植手术后,使用膝关节损伤和骨关节炎疗效评分(KOOS)对膝关节功能进行评估。我们进一步将这46例患者分为一组10例,他们未进行与微骨折术和透明质酸快速移植手术相关的其他操作。所有患者在术前均对患侧膝关节进行了磁共振成像(MRI)检查,2例患者在术后进行了MRI检查。由于另一起无关损伤,我们还获得了1例患者在微骨折术和透明质酸快速移植术后18个月膝关节的进一步关节镜检查结果。
与术前相比,第1年、第2年和第3年KOOS的所有类别(症状、疼痛、日常生活、运动和生活质量)均有统计学意义的改善。仅对于透明质酸快速移植亚组,与术前相比,第1年、第2年和第3年KOOS的症状、疼痛和日常生活类别有统计学意义的改善。
我们的研究表明,微骨折术后透明质酸快速移植对于4级软骨溃疡患者是一种可行的治疗替代方案。