Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, 49 North Garden Road, Haidian District, 100191, Beijing, People's Republic of China.
Department of Orthopedics, Affiliated Hospital to Shandong University of Traditional Chinese Medicine, 250011, Jinan, People's Republic of China.
Knee Surg Sports Traumatol Arthrosc. 2023 Aug;31(8):3509-3516. doi: 10.1007/s00167-023-07397-w. Epub 2023 Apr 3.
The purpose of this study was to retrospectively evaluate the clinical, arthroscopic and radiological outcomes of autologous osteoperiosteal transplantation for massive cystic osteochondral defects of the talus.
Cases of autologous osteoperiosteal transplantation for medial massive cystic defects of the talus between 2014 and 2018 were reviewed. The visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), and Ankle Activity Scale (AAS) were assessed preoperatively and postoperatively. The Magnetic Resonance Observation of Cartilage Tissue (MOCART) system and the International Cartilage Repair Society (ICRS) score were evaluated after surgery. The ability to return to daily activity and sport, as well as complications, were recorded.
Twenty-one patients were available for follow-up, with a mean follow-up of 60.1 ± 11.7 months. All subscales of preoperative FAOS had significant (P < 0.001) improvement at the final follow-up. The mean AOFAS and VAS scores significantly (P < 0.001) improved from 52.4 ± 12.4 preoperatively to 90.9 ± 5.2 at the last follow-up and from 7.9 ± 0.8 to 1.5 ± 0.9, respectively. The mean AAS decreased from 6.0 ± 1.4 preinjury to 1.4 ± 0.9 postinjury and then increased to 4.6 ± 1.4 at the final follow-up (P < 0.001). All 21 patients resumed daily activities after a mean of 3.1 ± 1.0 months. Fifteen patients (71.4%) returned to sports after a mean of 12.9 ± 4.1 months. All patients underwent follow-up MRI with a mean MOCART score of 68.6 ± 5.9. Eleven patients underwent second-look arthroscopy, and the average ICRS was 9.4 ± 0.8. No donor site morbidity was found in any patient during the follow-up.
Autologous osteoperiosteal transplantation provided favourable clinical, arthroscopic and radiographic outcomes in patients with massive cystic osteochondral defects of the talus during a minimum 3-year follow-up.
IV.
本研究旨在回顾性评估自体骨-骨膜移植治疗距骨巨大囊性骨软骨缺损的临床、关节镜和影像学结果。
回顾 2014 年至 2018 年间接受自体骨-骨膜移植治疗内侧距骨巨大囊性缺损的病例。术前和术后评估视觉模拟评分（VAS）、美国矫形足踝协会（AOFAS）评分、足踝结局评分（FAOS）和踝关节活动度评分（AAS）。术后采用磁共振软骨成像（MOCART）系统和国际软骨修复协会（ICRS）评分进行评估。记录患者重返日常活动和运动的能力以及并发症情况。
21 例患者获得随访，平均随访时间 60.1±11.7 个月。术前 FAOS 的所有亚量表在最终随访时均有显著（P<0.001）改善。AOFAS 和 VAS 评分均值分别从术前的 52.4±12.4 显著（P<0.001）改善至末次随访时的 90.9±5.2 和 7.9±0.8 至 1.5±0.9。AAS 均值从术前的 6.0±1.4 下降至术后的 1.4±0.9，然后在末次随访时增加至 4.6±1.4（P<0.001）。所有 21 例患者在平均 3.1±1.0 个月后恢复日常活动。15 例（71.4%）患者在平均 12.9±4.1 个月后重返运动。所有患者在平均随访时均接受 MRI 检查，MOCART 评分平均为 68.6±5.9。11 例行二次关节镜检查，ICRS 平均为 9.4±0.8。在随访期间，没有患者出现供区并发症。
在至少 3 年的随访中，自体骨-骨膜移植为距骨巨大囊性骨软骨缺损患者提供了良好的临床、关节镜和影像学结果。
IV。
