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仅行股骨髁暴露软骨下骨的自体骨软骨移植的中期疗效。

Midterm Outcomes of Autologous Osteochondral Graft Transplantation Only in the Femoral Condyle without Treating the Tibial Plateau with Subchondral Bone Exposed.

机构信息

Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

出版信息

Cartilage. 2021 Dec;13(1_suppl):1178S-1186S. doi: 10.1177/1947603520967066. Epub 2020 Oct 23.

Abstract

OBJECTIVE

This study aimed to examine the midterm clinical outcomes of autologous osteochondral grafts (AOG) that were performed in the femoral condyle without treating the tibial plateau with subchondral bone exposed, and to compare these outcomes with those of AOG used in patients with osteoarthritis (lateral type or medial type) or osteonecrosis.

DESIGN

The study included 6 men and 16 women and 11 right knees and 11 left knees. The mean operative age was 56.0 years (range, 21-76 years), and the mean follow-up period was 98.4 months (range, 60-164 months). Six patients had lateral type osteoarthritis (OAL), 7 had medial type osteoarthritis (OAM), and 9 had osteonecrosis (ON). The patients' knee symptoms as their clinical outcome were evaluated using the knee scoring system of the Japanese Orthopedic Association (JOA), and the International Knee Documentation Committee (IKDC) subjective score.

RESULTS

The postoperative clinical outcomes of the OAL and ON group were significantly better than their preoperative clinical scores and remained the same until the final follow-up. However, the clinical outcomes of OAM improved 2 years after AOG, but eventually decreased thereafter. The number of worse cases in the OAM group was significantly larger than those in the OAL and ON groups.

CONCLUSION

In these procedures, the postoperative clinical outcomes of the OAL and ON groups were significantly better than their preoperative clinical scores and were maintained for about 8 years. However, the clinical outcomes of OAM improved until 2 years after AOG, but eventually decreased thereafter.

摘要

目的

本研究旨在探讨不处理暴露软骨下骨的股骨髁骨软骨自体移植(AOG)的中期临床结果,并与膝骨关节炎(外侧型或内侧型)或骨坏死患者的 AOG 结果进行比较。

设计

研究纳入 6 名男性和 16 名女性,11 例右侧膝关节和 11 例左侧膝关节。平均手术年龄为 56.0 岁(范围,21-76 岁),平均随访时间为 98.4 个月(范围,60-164 个月)。6 例为外侧型骨关节炎(OAL),7 例为内侧型骨关节炎(OAM),9 例为骨坏死(ON)。采用日本矫形协会(JOA)膝关节评分系统和国际膝关节文献委员会(IKDC)主观评分评估患者膝关节症状作为临床结果。

结果

OAL 和 ON 组术后临床结果明显优于术前临床评分,并在最终随访时保持不变。然而,OAM 组的临床结果在 AOG 后 2 年改善,但此后逐渐下降。OAM 组的较差病例数明显多于 OAL 和 ON 组。

结论

在这些手术中,OAL 和 ON 组的术后临床结果明显优于术前临床评分,并保持约 8 年。然而,OAM 组的临床结果在 AOG 后 2 年改善,但此后逐渐下降。

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