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关节镜下单髁置换术治疗膝关节单间室骨关节炎的中期随访研究

Particulated Juvenile Articular Cartilage Allograft for Treatment of Chondral Defects of the Knee: Short-Term Survivorship with Functional Outcomes.

机构信息

Department of Orthopaedic Surgery, Wake Forest Baptist Health, Winston-Salem, North Carolina.

Central Indiana Orthopedics, Muncie, Indiana.

出版信息

J Surg Orthop Adv. 2021 Spring;30(1):10-13.

Abstract

While basic science research confirms the robust biological profile of juvenile chondrocytes, the clinical outcomes after particulated juvenile cartilage allograft transplantation are not well established. A retrospective analysis of active duty servicemembers undergoing surgical treatment with particulated juvenile articular cartilage allograft transplantation for chondral defects of the knee from two military treatment facilities was completed. Demographic variables, operative details, activity limitations, and medical discharges were obtained. A total of 29 patients with 36 treated chondral defects were isolated at an average follow-up of 16.2 months. The cohort was comprised of male service members in the Army with mean age of 33.1 years. Location of chondral lesion included the patellofemoral articulation (patella 39%, trochlea 31%, bipolar lesions 8%) and condyles (31%). Offloading or realignment osteotomy procedures were performed in 7 patients (23%). Of all patients, 14 servicemembers (48%) underwent knee-related medical discharge, and one patient underwent conversion to total knee arthroplasty. In this small patient cohort, particulated juvenile cartilage allograft transplantation for chondral defects of the knee did not reliably restore military servicemembers to full military function. At least one in two patients had persisting knee pain after chondral restoration procedure. (Journal of Surgical Orthopaedic Advances 30(1):010-013, 2021).

摘要

虽然基础科学研究证实了幼年软骨细胞强大的生物学特性,但颗粒状幼年软骨同种异体移植后临床效果尚未得到充分证实。对两家军事医疗机构接受颗粒状幼年关节软骨同种异体移植治疗膝关节软骨缺损的现役军人进行了回顾性分析。获得了人口统计学变量、手术细节、活动受限和医疗退役情况。共有 29 名患者 36 个软骨缺损接受了治疗,平均随访 16.2 个月。队列由陆军男性现役军人组成,平均年龄为 33.1 岁。软骨损伤部位包括髌股关节(髌骨 39%,滑车 31%,双极病变 8%)和髁间窝(31%)。7 例患者(23%)接受了减压或重新对线截骨术。所有患者中,14 名现役军人(48%)因膝关节相关原因退役,1 名患者转为全膝关节置换术。在这个小患者队列中,颗粒状幼年软骨同种异体移植治疗膝关节软骨缺损并不能可靠地使现役军人恢复到完全的军事功能。至少有一半的患者在软骨修复手术后仍有膝关节疼痛。(《外科矫形进展杂志》30(1):010-013,2021)。

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