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股骨远端软骨损伤微钻孔与微骨折修复组织磁共振观察评分及功能结果比较:一项回顾性对比研究

Comparison of Magnetic Resonance Observation of Cartilage Repair Tissue Score and Functional Outcomes between Microdrilling and Microfracture for Cartilage Lesions of Distal Femur: A Retrospective Comparative Study.

作者信息

Byun Junwoo, Jung Min, Chung Kwangho, Moon Hyun-Soo, Jung Se-Han, Kim Jin-Kyu, Kim Sung-Hwan

机构信息

Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

Department of Orthopedic Surgery, Mokdong Hospital, Ewha Womens University College of Medicine, Seoul, Republic of Korea.

出版信息

Cartilage. 2025 Jul 29:19476035251360504. doi: 10.1177/19476035251360504.

DOI:10.1177/19476035251360504
PMID:40726403
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12307329/
Abstract

ObjectiveThis study aimed to compare the clinical outcomes of microdrilling and microfracture for unipolar cartilage lesions of the distal femur.DesignPatients who underwent either microfracture or microdrilling and had postoperative magnetic resonance imaging (MRI) at 1 year were retrospectively reviewed. The morphology of the repaired cartilage tissue was evaluated using Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 score. Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) subjective, Lysholm scores, and Visual Analog Scale (VAS). In addition, the proportion of patients achieving improvement beyond the minimal clinically important difference (MCID) was analyzed.ResultsThe MOCART score was significantly higher in the microdrilling group. Among the variables, volume fill of the cartilage defect and integration into the adjacent cartilage showed significantly better results in favor of the microdrilling group. A higher proportion of patients achieved improvement in the IKDC subjective score beyond the MCID in the microdrilling group, whereas no significant differences were observed between the groups in Lyholm score and VAS.ConclusionMicrodrilling showed better outcomes in terms of the MOCART and IDKC subjective scores than microfracture, whereas Lysholm and VAS showed no significant differences. Further prospective studies are required to evaluate the results of these 2 procedures.

摘要

目的

本研究旨在比较微钻孔术与微骨折术治疗股骨远端单极软骨损伤的临床疗效。

设计

对接受微骨折术或微钻孔术且术后1年进行磁共振成像(MRI)检查的患者进行回顾性分析。使用软骨修复组织磁共振观察(MOCART)2.0评分评估修复软骨组织的形态。使用国际膝关节文献委员会(IKDC)主观评分、Lysholm评分和视觉模拟量表(VAS)评估功能结局。此外,分析达到最小临床重要差异(MCID)以上改善的患者比例。

结果

微钻孔组的MOCART评分显著更高。在各项变量中,软骨缺损的体积填充以及与相邻软骨的整合方面,微钻孔组的结果明显更好。微钻孔组中更高比例的患者在IKDC主观评分上达到了超过MCID的改善,而两组在Lysholm评分和VAS方面未观察到显著差异。

结论

就MOCART和IKDC主观评分而言,微钻孔术比微骨折术显示出更好的疗效,而Lysholm评分和VAS未显示出显著差异。需要进一步的前瞻性研究来评估这两种手术的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d312/12307329/5df11fece736/10.1177_19476035251360504-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d312/12307329/56c6de5ad5c0/10.1177_19476035251360504-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d312/12307329/5df11fece736/10.1177_19476035251360504-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d312/12307329/56c6de5ad5c0/10.1177_19476035251360504-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d312/12307329/5df11fece736/10.1177_19476035251360504-fig2.jpg

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Clin Orthop Surg. 2024 Aug;16(4):620-627. doi: 10.4055/cios23327. Epub 2024 Apr 25.
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