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采用壳聚糖支架结合微骨折术治疗髌股软骨病变:中期临床和放射学结果。

Treatment of Patellofemoral Chondral Lesions Using Microfractures Associated with a Chitosan Scaffold: Mid-Term Clinical and Radiological Results.

机构信息

Clinica Alemana-Universidad del Desarrollo, Santiago, Chile.

Hospital Sotero del Rio, Santiago, Chile.

出版信息

Cartilage. 2021 Dec;13(1_suppl):1258S-1264S. doi: 10.1177/19476035211011506. Epub 2021 Apr 27.

Abstract

OBJECTIVE

To assess the clinical and radiological results of patellofemoral osteochondral lesions treated with microfractures associated with a chitosan scaffold.

DESIGN

A retrospective observational analytical study was performed. Fifteen patients with full-thickness patellofemoral osteochondral lesions were included. Quantity and quality of the reparation cartilage was assessed with the MOCART 2.0 score on a postoperative magnetic resonance imaging (MRI), and clinical outcomes were evaluated with pre- and postoperative Kujala score tests. Shapiro-Wilk test for normality was applied as well as Wilcoxon's signed rank test and Kruskal-Wallis H test for clinical scores within subjects and patella versus trochlea subgroups comparisons. Analysis of variance test was used for imaging subgroups comparison, with < 0.05 defined as statistical significance.

RESULTS

Mean follow-up was 33.36 months (range 24-60 months). Postoperative Kujala scores improved an average of 19 points compared with the preoperative state (SE = 17.6; < 0.001). No statistical difference was found through the clinical location assessment ( = 0.756), as well as the cartilage imaging assessment ( = 0.756). The mean MOCART 2.0 scale was 67.67 (range 50-85).

CONCLUSIONS

Treating full-thickness patellofemoral osteochondral lesions with microfractures associated with a chitosan scaffold proved to be effective regarding defect filling and symptomatic improvement.

摘要

目的

评估微骨折联合壳聚糖支架治疗髌股骨软骨病变的临床和影像学结果。

设计

回顾性观察分析研究。纳入 15 例全层髌股骨软骨病变患者。术后磁共振成像(MRI)采用 MOCART 2.0 评分评估修复软骨的数量和质量,采用术前和术后 Kujala 评分测试评估临床结果。应用 Shapiro-Wilk 检验进行正态性检验,Wilcoxon 符号秩检验和 Kruskal-Wallis H 检验用于受试者内和髌骨与滑车亚组比较的临床评分。方差分析用于影像学亚组比较,以 < 0.05 为统计学意义。

结果

平均随访 33.36 个月(范围 24-60 个月)。与术前相比,术后 Kujala 评分平均提高 19 分(SE = 17.6; < 0.001)。临床部位评估( = 0.756)和软骨影像学评估( = 0.756)均无统计学差异。MOCART 2.0 平均评分为 67.67(范围 50-85)。

结论

微骨折联合壳聚糖支架治疗全层髌股骨软骨病变在改善症状和填充缺损方面是有效的。

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