Bobić V
Royal Devon and Exeter Healthcare NHS Trust, Princess Elizabeth Orthopaedic Hospital, UK.
Knee Surg Sports Traumatol Arthrosc. 1996;3(4):262-4. doi: 10.1007/BF01466630.
The high incidence of chondral defects of the femoral condyles associated with chronic ACL tears is widely recognised. However, treatment is difficult and controversial. This preliminary report presents our experience with arthroscopic osteochondral autograft transplantation in ACL-deficient knees. The series consists of 12 cases of arthroscopic osteochondral autograft transplantation in conjunction with ACL reconstruction using bone-patellar tendon-bone autograft; eight procedures were primary, and four were revisions of failed synthetic grafts. The patients' ages ranged from 22 to 42 years. There were ten male and two female patients. Chondral lesions in this series ranged from 10 to 22 mm in diameter. Donor site was selected prior to notchplasty, and three to five osteochondral cylinders, 5-10 mm in diameter, 10-15 mm long, were harvested. Improved surgical technique, tubular cutting instruments enabling minimal damage to harvested articular cartilage, and press-fit insertion yielded promising uniform results in ten of 12 cases with 2 years' follow-up. This study addresses the important issue of articular cartilage defects in ACL-deficient knees and possible prevention of premature joint degeneration. The aim of arthroscopic osteochondral autograft transplantation is to slow down the development of osteoarthrosis.
股骨髁软骨损伤与慢性前交叉韧带撕裂相关的高发生率已得到广泛认可。然而，治疗困难且存在争议。本初步报告介绍了我们在ACL缺失膝关节中进行关节镜下自体骨软骨移植的经验。该系列包括12例关节镜下自体骨软骨移植联合使用自体髌腱骨进行ACL重建的病例；8例为初次手术，4例为失败的合成移植物的翻修手术。患者年龄在22至42岁之间。男性10例，女性2例。该系列中的软骨损伤直径为10至22毫米。在进行髁间窝成形术前选择供区，采集3至5个直径5至10毫米、长10至15毫米的骨软骨柱。改进的手术技术、能使采集的关节软骨损伤最小化的管状切割器械以及压配式植入，在12例中的10例患者中获得了有前景的一致结果，随访2年。本研究探讨了ACL缺失膝关节中关节软骨缺损这一重要问题以及预防关节过早退变的可能性。关节镜下自体骨软骨移植的目的是减缓骨关节炎的发展。
