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关节镜下骨移植治疗距骨Hepple V期骨软骨损伤的疗效

Outcomes of arthroscopic bone graft transplantation for Hepple stage V osteochondral lesions of the talus.

作者信息

Li Shengkun, Lu Rong, Zhang Jian, Tao Hongyue, Hua Yinghui

机构信息

Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.

Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Ann Transl Med. 2021 May;9(10):884. doi: 10.21037/atm-21-2006.

Abstract

BACKGROUND

Based on MRI imaging findings, osteochondral lesions of the talus (OLT) can be classified into five stages, in which stage V represents OLT with subchondral cyst formation. The aim of this study was to evaluate the outcomes of patients undergoing arthroscopic transplantation of calcaneus bone graft for Hepple stage V OLT.

METHODS

This retrospective study included 24 patients with Hepple stage V OLT (15 men and 9 women), with an average age of 39.8±12.9 years old. The mean follow-up period was 18.9±11.8 months. At this follow-up, all patients were clinically evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) score, the Karlsson Ankle Function Score (KAFS), the Tegner score, and the visual analogue scale (VAS). Furthermore, 14 patients underwent MRI imaging examinations, and the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 score was assessed.

RESULTS

The AOFAS score, KAFS, Tegner activity score, and VAS pain score (preoperative: 62.2, 60.4, 2.1, and 6.2, respectively; postoperative: 92.8, 88.5, 4.2, and 1.6, respectively) improved significantly (P=0.0001). The MRI-based MOCART score of the articular cartilage repair tissue after surgery was 68±14.8.

CONCLUSIONS

Arthroscopic transplantation of calcaneus bone graft for Hepple stage V OLT could obtain satisfying clinical and radiological outcomes in the short-term.

摘要

背景

根据磁共振成像(MRI)检查结果,距骨骨软骨损伤(OLT)可分为五个阶段,其中V期代表伴有软骨下囊肿形成的OLT。本研究旨在评估接受关节镜下跟骨骨移植治疗Hepple V期OLT患者的疗效。

方法

本回顾性研究纳入24例Hepple V期OLT患者(男15例,女9例),平均年龄39.8±12.9岁。平均随访时间为18.9±11.8个月。在此次随访中,所有患者均使用美国矫形足踝协会(AOFAS)评分、卡尔森踝关节功能评分(KAFS)、特格纳评分和视觉模拟量表(VAS)进行临床评估。此外,14例患者接受了MRI检查,并评估了软骨修复组织的磁共振观察(MOCART)2.0评分。

结果

AOFAS评分、KAFS、特格纳活动评分和VAS疼痛评分(术前分别为62.2、60.4、2.1和6.2;术后分别为92.8、88.5、4.2和1.6)均显著改善(P = 0.0001)。术后关节软骨修复组织基于MRI的MOCART评分为68±14.8。

结论

关节镜下跟骨骨移植治疗Hepple V期OLT在短期内可获得满意的临床和影像学效果。

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