Dávila Castrodad Iciar M, Simone Erica S, Kurowicki Jennifer, Melendez Justin X, Mease Samuel J, McInerney Vincent K, Scillia Anthony J
Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey, U.S.A.
New Jersey Orthopaedic Institute, Wayne, New Jersey, U.S.A.
Arthrosc Sports Med Rehabil. 2021 Feb 24;3(2):e477-e484. doi: 10.1016/j.asmr.2020.11.002. eCollection 2021 Apr.
To assess the postoperative objective, subjective, and functional outcomes as well as complication rates in osteochondral defect patients treated with bone marrow aspirate concentrate (BMAC) and cartilage-derived matrix (CDM) during knee arthroscopy.
A retrospective chart review was performed for patients treated arthroscopically with BMAC and CDM between August 2015 and August 2018 and had more than 1-year follow-up. Demographic factors such as age, sex, body mass index, and comorbidities were collected for all patients. Size and location of the osteochondral lesions also were documented.
A total of 14 patients were identified with a mean follow-up of 19 months. On average, patients were 34 years of age (range 16-58 years) and 43% were female. Postoperatively, knee flexion increased by 8° from 124° to 132° ( = .002). All patients regained full extension; however, 1 patient later acquired a 2° extension contracture after a traumatic event. The average hamstring strength significantly increased from 4.1 to 4.6 postoperatively ( = .33). The average quadriceps strength significantly increased from 4.0 to 4.5 postoperatively ( = .007). Mean visual analog scale scores significantly decreased postoperatively (4.5 vs 1.4; = .001). There was a significant increase in Knee Outcome Survey Activities of Daily Living scores (53.8 vs 92.9; = .007). Mean Knee Outcome Survey-Sports scores also increased, although this was nonsignificant (28.2 vs 79.5; = .560). No significant differences were noted in pain and functional outcomes when stratified by the osteochondral defect size and location. Complications included a stitch abscess, Baker's cyst, and residual pain treated with hyaluronic acid injection.
This study demonstrated arthroscopic BMAC and CDM implantation appears to be safe and has the potential to improve patient outcomes in the short-term postoperative period.
IV, therapeutic case series.
评估在膝关节镜检查期间接受骨髓抽吸浓缩物（BMAC）和软骨衍生基质（CDM）治疗的骨软骨缺损患者的术后客观、主观和功能结果以及并发症发生率。
对2015年8月至2018年8月间接受BMAC和CDM关节镜治疗且随访超过1年的患者进行回顾性病历审查。收集所有患者的人口统计学因素，如年龄、性别、体重指数和合并症。还记录了骨软骨损伤的大小和位置。
共确定14例患者，平均随访19个月。患者平均年龄34岁（范围16 - 58岁），43%为女性。术后，膝关节屈曲从124°增加到132°，增加了8°（P = .002）。所有患者均恢复了完全伸直；然而，1例患者在创伤事件后出现了2°的伸直挛缩。术后平均腘绳肌力量从4.1显著增加到4.6（P = .33）。术后平均股四头肌力量从4.0显著增加到4.5（P = .007）。术后视觉模拟量表平均评分显著降低（4.5对1.4；P = .001）。膝关节结果调查日常生活活动评分显著增加（53.8对92.9；P = .007）。膝关节结果调查 - 运动评分也有所增加，尽管不显著（28.2对79.5；P = .560）。按骨软骨缺损大小和位置分层时，疼痛和功能结果无显著差异。并发症包括缝线脓肿、贝克囊肿和用透明质酸注射治疗的残留疼痛。
本研究表明，关节镜下植入BMAC和CDM似乎是安全的，并且有可能在术后短期内改善患者的结果。
IV，治疗性病例系列。
