Orthopedic Department, Faculty of Medicine, Ain Shams University, Cairo Governorate, Egypt.
Arch Orthop Trauma Surg. 2024 Aug;144(8):3479-3489. doi: 10.1007/s00402-024-05413-3. Epub 2024 Jul 15.
Fresh osteochondral allograft transplantation is a good treatment option of cartilage defects. However, this treatment option is not available in all countries due to limited graft availability and tissue banks limitations. The purpose of this study is to assess the short term functional and imaging outcomes of fresh osteochondral allograft transplantation in the knee using the femoral head of living donors.
Fresh osteochondral allografts from the femoral heads of living donors is a valid graft source for management of distal Femur cartilage defects. This technique can improve functional knee scores with good radiological outcomes.
Prospective case series.
Fifteen patients with full thickness cartilage defects of the distal femur underwent osteochondral allograft transplantation from the femoral heads of living donors. Grafts were transplanted by both shell and multiple dowels techniques. The average follow up duration was 18.3 months (range, 12-25 months). Patients were evaluated by Lysholm and International Knee Documentation Committee (IKDC) scores, radiography and MR imaging using Osteochondral Allograft MRI Scoring System (OCAMRISS).
There was a statistically significant improvement (P < 0.001) in both Lysholm and IKDC average scores at 6 months and 12 months postoperative. Postoperative MRI was done at an average 6.8 months (range, 5-11 months) postoperative. The mean total OCAMRISS score was 3.4 (range, 1-7). A second look arthroscopy was done in four patients and showed intact articular cartilage in all three patients.
Femoral head of living donors is a valid new source for fresh osteochondral allograft transplantation of knee osteochondral lesions. Short term results showed improvement in clinical assessment scores. Follow up imaging showed graft incorporation and good MRI scores.
新鲜骨软骨同种异体移植是治疗软骨缺损的一种较好的选择。然而,由于供体有限和组织库的限制,并非所有国家都能提供这种治疗方法。本研究的目的是评估使用活体供体股骨头进行新鲜骨软骨同种异体移植治疗膝关节骨软骨病变的短期功能和影像学结果。
来自活体供体股骨头的新鲜骨软骨同种异体移植物是治疗股骨远端软骨缺损的有效移植物来源。这种技术可以改善膝关节功能评分,获得良好的影像学结果。
前瞻性病例系列研究。
15 例股骨远端全层软骨缺损患者接受了来自活体供体股骨头的骨软骨同种异体移植。采用壳和多栓钉技术进行移植。平均随访时间为 18.3 个月(范围 12-25 个月)。采用 Lysholm 和国际膝关节文献委员会(IKDC)评分、放射学和磁共振成像(使用骨软骨同种异体 MRI 评分系统 [OCAMRISS])评估患者。
术后 6 个月和 12 个月时,Lysholm 和 IKDC 平均评分均有统计学显著改善(P < 0.001)。术后平均 6.8 个月(范围 5-11 个月)行 MRI 检查。平均 OCAMRISS 总分为 3.4(范围 1-7)。对 4 例患者进行了二次关节镜检查,3 例患者的关节软骨均完整。
来自活体供体的股骨头是膝关节骨软骨病变新鲜骨软骨同种异体移植的有效新来源。短期结果显示临床评估评分有所改善。随访影像学显示移植物融合和良好的 MRI 评分。