自体骨软骨移植治疗距骨囊性骨软骨损伤
Primary Osteochondral Autograft Transfer for the Treatment of Cystic Osteochondral Lesions of the Talus.
作者信息
Kızılay Yusuf Onur, Kezer Murat
机构信息
*Department of Orthopedics and Traumatology, VM Medical Park Bursa Hospital, Osmangazi/Bursa, Turkey.
†Department of Orthopedics and Traumatology, Bursa Osmangazi Aritmi Hospital, Osmangazi/Bursa, Turkey.
出版信息
J Am Podiatr Med Assoc. 2025 Jul-Aug;115(4). doi: 10.7547/24-052.
BACKGROUND
The need for intra-articular osteotomy and potential complications at the donor site may lead some surgeons to avoid using the osteochondral autograft transfer method as a primary surgery, instead considering it a revision procedure for osteochondral lesions of the talus. In this retrospective study, we hypothesized that the primary application of osteochondral autograft transfer in cystic talar osteochondral lesions would yield good results and intra-articular osteotomy and donor site would not have a negative effect on long-term clinical outcomes. The primary objective of this study was to demonstrate that osteochondral autograft transfer can be safely applied as a primary treatment for cystic talar osteochondral lesions.
METHODS
In our study, 21 patients underwent primary osteochondral autograft transfer for cystic talar osteochondral lesions. Demographic data of patients, including age, gender, and body mass index, as well as duration of symptoms, etiology of the lesion, location of the lesion, and follow-up duration were recorded from our medical records. The clinical evaluation used the visual analog scale for pain, function, and satisfaction along with the American Orthopaedic Foot & Ankle Society score. In addition, the magnetic resonance observation of cartilage repair tissue scale was used for evaluation of graft healing.
RESULTS
The mean follow-up time was 32 months. According to the results of the study, compared with the preoperative status, statistically significant improvement was observed in visual analog scale pain, function, and satisfaction scores as well as in the American College of Foot and Ankle Surgeons score. In addition to these findings, it was observed that there was no negative effect of intra-articular osteotomy and donor site on long-term results.
CONCLUSIONS
Our study showed that osteochondral autograft transfer can be safely applied as primary surgery in cystic talar osteochondral lesions.
背景
关节内截骨的必要性以及供区可能出现的并发症，可能导致一些外科医生避免将自体骨软骨移植方法作为初次手术，而是将其视为距骨骨软骨损伤的翻修手术。在这项回顾性研究中，我们假设在囊性距骨骨软骨损伤中初次应用自体骨软骨移植会取得良好效果，并且关节内截骨和供区不会对长期临床结果产生负面影响。本研究的主要目的是证明自体骨软骨移植可安全地作为囊性距骨骨软骨损伤的初次治疗方法。
方法
在我们的研究中，21例患者因囊性距骨骨软骨损伤接受了初次自体骨软骨移植。从我们的病历中记录了患者的人口统计学数据，包括年龄、性别和体重指数，以及症状持续时间、损伤病因、损伤部位和随访时间。临床评估使用视觉模拟疼痛量表、功能量表、满意度量表以及美国矫形足踝协会评分。此外，使用磁共振软骨修复组织观察量表评估移植物愈合情况。
结果
平均随访时间为32个月。根据研究结果，与术前状态相比，视觉模拟疼痛量表、功能量表、满意度量表以及美国足踝外科医师学会评分均有统计学意义的显著改善。除了这些发现，还观察到关节内截骨和供区对长期结果没有负面影响。
结论
我们的研究表明，自体骨软骨移植可安全地作为囊性距骨骨软骨损伤的初次手术方法。
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