| 骨软骨镶嵌移植术与微骨折术治疗膝关节软骨损伤的疗效比较 |
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投稿时间：2018-08-19 修订日期：2018-10-06
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
| DOI： |
| 基金项目:全军医药卫生科研基金课题(15MS021)；宁波市体育科学研究课题(795SS1711) |
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| 中文摘要:目的:对比评估微骨折术与自体骨软骨镶嵌移植术治疗膝关节软骨损伤的临床疗效差异。方法:回顾性分析2011年2月至2016年2月采用微骨折术或自体骨软骨镶嵌移植术治疗且随访时间≥2年的71例膝关节股骨远端关节面软骨损伤患者资料,按手术方式不同分为2组：微骨折组33例,男20例,女13例,平均年龄为(28.1±4.2)岁；移植组38例,男26例,女12例,平均年龄为(27.8±3.5)岁。采用Lysholm评分、美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS)、Ahlb?ck骨关节炎分级系统进行评估,并记录术后并发症。结果:微骨折组与移植组的Lysholm评分,分别由术前平均(62.9±6.8)、(60.3±7.5)分提高到术后的(77.0±5.4)、(85.8±5.6)分(P＜0.01)；HSS评分分别由术前平均(81.5±7.6)、(79.6±8.6)分改善为(88.0±4.7)、(91.9±4.7)分(P＜0.01)。移植组术后的平均Lysholm评分与HSS评分,均高于微骨折组,差异有统计学意义。移植组发生切口浅表感染1例。随访未发现患者出现膝关节骨关节炎。结论:自体骨软骨镶嵌移植术与微骨折术治疗膝关节软骨损伤均安全、有效,但自体骨软骨镶嵌移植术比微骨折术临床疗效更佳。 |
| 【关键词】镶嵌术 自体骨软骨移植 微骨折术 膝 关节软骨损伤 |
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| Autogenous osteochondral mosaicplasty versus microfracture in knee articular cartilage defects |
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| ABSTRACT Objective:To compare the clinical outcomes of autogenous osteochondral mosaicplasty versus microfracture in symptomatic knee articular cartilage defects. Methods:Enrolled for this study were 71 patients with articular cartilage defects on the femoral condyles who had been treated by autogenous osteochondral mosaicplasty or microfracture from February 2011 to February 2016 and followed up for at least two year．According to the sugical procedures, they were divided into two groups. In the microfracture group,there were 33 patients,20 males and 13 females, with a mean age of 28.1±4.2 years; in the mosaicplasty gloup, there were 38 patients, 26 males and 12 females, with a mean age of 27.8±3.5 years. The Lysholm knee score, Hospital for Special Surgery (HSS) knee score and the Ahlb?ck classification grade were recorded to evaluate the clinical efficacy. Complications were also recorded. Results:The mean Lysholm scores of the microfracture group and the mosaicplasty group improved from (62.9±6.8) and (60.3±7.5) points preoperatively to (77.0±5.4) and (85.8±5.6) points post-operatively, respectively (P＜0.01). Mean HSS scores of the microfracture group and the mosaicplasty group improved from (81.5±7.6) and (79.6±8.6) points preoperatively to (88.0±4.7) and (91.9±4.7) points post-operatively, respectively (P＜0.01). The mean Lysholm score and HSS score were significantly higher in the mosaicplasty group than the microfracture group at the last follow-up. One patient in the mosaicplasty group suffered superficial wound infection. At follow-up, no knee osteoarthritis was observed in two groups. Conclusion:Autogenous osteochondral mosaicplasty and microfracture are proved to be safe and effective procedures for knee articular cartilage defects. However, the mosaicplasty leads to clinically relevant better outcome than the microfracture. |
| KEY WORDS Mosaicplasty Osteochondral autograft transfer Microfracture Knee Articular cartilage defects |
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