Díaz-Dilernia Fernando, Astore Franco, Buttaro Martin, Zanotti Gerardo
Sunnybrook Health Sciences Centre/Holland Orthopaedic & Arthritic Centre, Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Hip Surgery Unit, Institute of Orthopaedics "Carlos E. Ottolenghi", Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
Hip Pelvis. 2022 Sep;34(3):177-184. doi: 10.5371/hp.2022.34.3.177. Epub 2022 Sep 30.
This study aimed to analyse the initial results of five patients with symptomatic osteochondral lesions (OCL) and femoroacetabular impingement (FAI) who were treated successfully with osteochondral autologous transfer (OAT) and femoral neck osteochondroplasty (OCP) through surgical dislocation of the hip. Five patients with FAI and OCL of the femoral head who underwent surgery between 2015-2018 were studied retrospectively. All patients had a grade IV OCL, and the median defect size was 2 cm (interquartile range [IQR], 2-2). At the final follow-up, the modified Harris hip score showed a median value of 94 (IQR, 91-95) (=0.04). Pain evaluation using the visual analogue scale showed a median value of 1 (IQR, 1-2) (=0.04). Adequate graft union and healthy formation of the chondral surface were observed by magnetic resonance imaging. Although the procedure is demanding, the combination of OAT and femoral neck OCP appears to be an effective alternative in young patients.
本研究旨在分析5例有症状的骨软骨损伤（OCL）和股骨髋臼撞击症（FAI）患者的初步治疗结果，这些患者通过髋关节手术脱位，成功接受了自体骨软骨移植（OAT）和股骨颈骨软骨成形术（OCP）。对2015年至2018年间接受手术的5例患有FAI和股骨头OCL的患者进行了回顾性研究。所有患者均为IV级OCL，缺损大小中位数为2 cm（四分位间距[IQR]，2 - 2）。在末次随访时，改良Harris髋关节评分中位数为94（IQR，91 - 95）（P = 0.04）。采用视觉模拟量表进行的疼痛评估中位数为1（IQR，1 - 2）（P = 0.04）。通过磁共振成像观察到移植骨充分愈合且软骨表面形成良好。尽管该手术要求较高，但OAT与股骨颈OCP联合应用似乎是年轻患者的一种有效替代治疗方法。
