Choi Eun Seok, Shin Hyun Dae
Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Chungnam National University Hospital, 266 Munhwa-ro, Jung-gu, Daejeon, 35015 Republic of Korea.
Indian J Orthop. 2020 May 6;54(Suppl 1):27-32. doi: 10.1007/s43465-020-00126-2. eCollection 2020 Sep.
This study aimed to introduce the medulloscopy-assisted autologous bone graft for osteonecrosis of the knee following adolescent leukemia treatment and to report the mid-term clinical and radiological results.
We retrospectively reviewed records of eight consecutive knees in six patients with extensive osteonecrosis of the distal femoral condyles, from 2013 to 2015. All patients were treated with autologous bone grafts using medulloscopy. We evaluated functional and objective Knee Society Score (KSS) pre- and postoperatively. Clinical and radiological outcomes were evaluated at the last follow-up.
The mean age of the patients at the time of surgery was 21.5 years. The mean follow-up period was 45 months. No additional surgery was required during the follow-up period. The mean objective KSS significantly increased from 60.6 points (range 55-65) to 90.0 points (range 70-95), postoperatively ( < 0.001). The mean functional KSS significantly improved from 48.8 points (range 45-55) to 90.0 points (range 80-100) postoperatively ( < 0.001). No patients had progression of collapse of the femoral condyles at the final follow-up. At the final follow-up, the onset of minimal osteoarthritis was seen in two knees, with a Kellgren-Lawrence grade 1.
Medulloscopy-assisted bone grafting can be an effective treatment option for early symptomatic osteonecrosis of knee following treatment for adolescent leukemia.
本研究旨在介绍用于青少年白血病治疗后膝关节骨坏死的髓腔镜辅助自体骨移植，并报告中期临床和影像学结果。
我们回顾性分析了2013年至2015年6例股骨远端髁广泛骨坏死患者连续8个膝关节的记录。所有患者均采用髓腔镜辅助进行自体骨移植。我们评估了术前和术后的膝关节功能及客观膝关节协会评分（KSS）。在最后一次随访时评估临床和影像学结果。
手术时患者的平均年龄为21.5岁。平均随访期为45个月。随访期间无需额外手术。术后平均客观KSS从60.6分（范围55 - 65分）显著提高到90.0分（范围70 - 95分）（<0.001）。术后平均功能KSS从48.8分（范围45 - 55分）显著改善到90.0分（范围80 - 100分）（<0.001）。在最后一次随访时，没有患者出现股骨髁塌陷进展。在最后一次随访时，两个膝关节出现轻度骨关节炎，Kellgren-Lawrence分级为1级。
髓腔镜辅助骨移植可作为青少年白血病治疗后早期有症状膝关节骨坏死的有效治疗选择。
