Md Yusoff Badrul Akmal Hisham, Hazli Muhammad Ikmal, Mohamad Norlelawati, Ramlan Muhamad Karbela Reza, Kamrulzaman Nik Kamarul Arif Bin Nik, Rameez Mohamed Razzan, Aziz Mohamad Azwan
Department of Orthopaedic, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Department of Orthopaedic, Hospital Chancellor Tuanku Mukhriz, Kuala Lumpur, Malaysia.
PLoS One. 2025 Jul 24;20(7):e0328978. doi: 10.1371/journal.pone.0328978. eCollection 2025.
This study aims to determine the clinical outcomes of a new technique of cartilage repair surgery, using calcified cartilage zone debridement coupled with Hyalofast and bone marrow aspirate concentrate, in terms of pain and functional outcomes.
This was a retrospective case series in 19 patients with cartilage injuries, ICRS 3 and 4. Using arthroscopic examination, cartilage defects were identified and debrided. Then, the calcified cartilage zone was identified and scrapped, until punctate bleeding occurred. Hyalofast was fixed into the defect and bone marrow aspirate concentrate was injected into the Hyalofast. Patients were followed up at baseline, 1, 6, and 18 months post-operative, using visual analog scale, KOOS, IKDC, and Lysholm Score.
The mean age was 45.33 ± 9.68 years, with the mean cartilage defects of 10.21 ± 11.10 X 9.43 ± 10.85 mm2. Among the cohort, seven patients (36.8%) underwent three chondral repair procedures, five (26.4%) received two procedures, and the remaining seven (36.8%) were treated with a single procedure. In the KOOS subscale, there was a steady improvement; symptoms (mean difference: -23.87, CI: -43.97 - -3.77, p-value = 0.015), pain (mean difference: -28.39, CI: -43.94 - -12.83, p-value = 0.001), activity of daily living (mean difference: -26.23, CI: -40.95 - -10.14, p-value = 0.001), and sports subscale (mean difference: -57.36, CI: -80.76 - -33.97, p-value < 0.001).
The calcified cartilage zone debridement technique served as a novel technique to preserve subchondral plate allowing better outcomes for cartilage repair.
本研究旨在确定一种新的软骨修复手术技术的临床效果，该技术采用钙化软骨区清创术结合透明质酸速凝贴和骨髓抽吸浓缩物，评估其在疼痛和功能方面的效果。
这是一项针对19例软骨损伤（国际软骨修复协会[ICRS]3级和4级）患者的回顾性病例系列研究。通过关节镜检查确定并清理软骨缺损。然后，识别并刮除钙化软骨区，直至出现点状出血。将透明质酸速凝贴固定于缺损处，并将骨髓抽吸浓缩物注入透明质酸速凝贴中。在基线、术后1个月、6个月和18个月对患者进行随访，使用视觉模拟量表、膝关节损伤和骨关节炎疗效评分（KOOS）、国际膝关节文献委员会（IKDC）评分和Lysholm评分。
患者平均年龄为45.33±9.68岁，平均软骨缺损面积为10.21±11.10×9.43±10.85平方毫米。在该队列中，7例患者（36.8%）接受了三次软骨修复手术，5例（26.4%）接受了两次手术，其余7例（36.8%）接受了一次手术。在KOOS子量表中，有稳步改善；症状（平均差异：-23.87，可信区间：-43.97至-3.77，p值=0.015）、疼痛（平均差异：-28.39，可信区间：-43.94至-12.83，p值=0.001）、日常生活活动（平均差异：-26.23，可信区间：-40.95至-10.14，p值=0.001）和运动子量表（平均差异：-57.36，可信区间：-80.76至-33.97，p值<0.001）。
钙化软骨区清创技术是一种保留软骨下骨板的新技术，能为软骨修复带来更好的效果。
