Howell Matthew, Liao Quintin, Gee Christopher W
Department of Trauma and Orthopaedics, The Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, Scotland.
Department of Trauma and Orthopaedics, University Hospital Wishaw, 50 Netherton St, Wishaw, Scotland.
Curr Rev Musculoskelet Med. 2021 Feb;14(1):60-66. doi: 10.1007/s12178-020-09685-1. Epub 2021 Feb 15.
Numerous surgical techniques are available to treat osteochondral defects of the knee. The aim of this review is to analyse these procedures, including their methodology, outcomes and limitations, to create a treatment algorithm for optimal management.
Osteochondral defects of the knee significantly alter the biomechanics of the joint. This can cause symptomatic and functional impairment as well as considerable risk of progressive joint degeneration. Surgical interventions aim to restore a congruent, durable joint surface providing symptomatic relief and reducing the risk of early arthritic changes. These methods include fixation, chondroplasty, microfracture, autologous matrix-induced chondrogenesis, autograft transplants, allograft transplants and autologous chondrocyte implantation. There is currently much debate as to which of these methods provides optimal treatment of osteochondral defects. The overall evidence supports the use of each technique depending on the individual characteristics of the lesion. New technologies provide exciting prospects; however, long-term outcomes for these are not yet available.
有多种手术技术可用于治疗膝关节骨软骨损伤。本综述旨在分析这些手术方法,包括其操作方法、疗效及局限性,以制定最佳治疗的算法。
膝关节骨软骨损伤会显著改变关节的生物力学。这会导致症状性和功能性损害,以及关节进行性退变的高风险。手术干预旨在恢复一个一致、持久的关节表面,以缓解症状并降低早期关节炎改变的风险。这些方法包括固定、软骨成形术、微骨折术、自体基质诱导软骨形成、自体移植、异体移植和自体软骨细胞植入。目前对于这些方法中哪种能为骨软骨损伤提供最佳治疗存在诸多争论。总体证据支持根据损伤的个体特征使用每种技术。新技术带来了令人兴奋的前景;然而,其长期疗效尚无相关报道。