Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Centro de Cirurgia do Joelho, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, Brazil.
Cartilage. 2024 Jun;15(2):77-83. doi: 10.1177/19476035231207780. Epub 2023 Oct 18.
We aimed to evaluate the outcomes, survivorship, and complications following multi-surface cartilage procedures at minimum 2-year follow-up.
Patients with either (1) single-surface osteochondral allograft transplantation (OCAT) with third-generation matrix-induced autologous cultured chondrocyte implantation (MACI) or particulated juvenile cartilage implantation (DeNovo), or (2) multiple-surface OCAT ± associated MACI/DeNovo procedures for grade IV chondral or osteochondral defects about the knee with minimum 2-year follow-up were analyzed. Patient-reported outcome measures (PROMs), including International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, were obtained preoperatively and at minimum 2 years postoperatively. The percentage of patients who met the minimal clinically important difference (MCID) for each PROM was reported. Failure was defined as revision OCAT, conversion to patellofemoral/total/unicompartmental joint arthroplasty, or Arthrosurface HemiCAP placement.
Of 257 patients identified, 35 were included. There was a significant increase in IKDC, KOOS-pain, KOOS-symptom, KOOS-sport, and KOOS-quality of life scores from preoperative to postoperative evaluation ( < 0.03 for all). More than 50% of patients met the MCID for each PROM. There were 2 failures, 1 of the patella and 1 of the medial femoral condyle, at 39.7 and 38.6 months postoperatively, respectively.
Multi-surface cartilage procedures are a safe, efficacious treatment option for multifocal cartilage defects about the knee at short-term follow-up.
我们旨在评估至少 2 年随访时多层面软骨手术的结果、存活率和并发症。
分析了至少 2 年随访时接受单层面骨软骨同种异体移植（OCAT）联合第三代基质诱导自体培养软骨细胞植入（MACI）或颗粒状幼年软骨植入（DeNovo），或多层面 OCAT±相关 MACI/DeNovo 手术治疗膝关节 4 级软骨或骨软骨缺损的患者。术前和至少 2 年术后均采用国际膝关节文献委员会（IKDC）和膝关节损伤和骨关节炎评分（KOOS）亚量表评估患者报告的结果测量（PROM）。报告了每个 PROM 达到最小临床重要差异（MCID）的患者比例。失败定义为翻修 OCAT、转换为髌股/全/单间室关节置换术或 Arthrosurface HemiCAP 植入。
在确定的 257 名患者中，有 35 名患者入选。与术前评估相比，IKDC、KOOS-疼痛、KOOS-症状、KOOS-运动和 KOOS-生活质量评分均显著增加（<0.03）。超过 50%的患者在每个 PROM 中达到了 MCID。术后 39.7 个月和 38.6 个月分别有 1 例髌骨和 1 例股骨内侧髁失败。
多层面软骨手术是治疗膝关节多灶性软骨缺损的一种安全、有效的短期治疗选择。
