| 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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Received:October 06, 2018
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| 作者 | Author | 单位 | Unit | E-Mail |
| 黄承 |
HUANG Cheng |
解放军第113医院关节骨病运动医学科, 浙江 宁波 315040 |
Department of Joint Surgery and Sports Medicine, the 113 th Hospital of People Liberation Army, Ningbo 315040, Zhejiang, China |
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| 陆志剀 |
LU Zhi-kai |
解放军第113医院关节骨病运动医学科, 浙江 宁波 315040 |
Department of Joint Surgery and Sports Medicine, the 113 th Hospital of People Liberation Army, Ningbo 315040, Zhejiang, China |
jfj113lzk@163.com |
| 黄晨 |
HUANG Chen |
解放军第113医院关节骨病运动医学科, 浙江 宁波 315040 |
Department of Joint Surgery and Sports Medicine, the 113 th Hospital of People Liberation Army, Ningbo 315040, Zhejiang, China |
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| 王飞 |
WANG Fei |
解放军第113医院关节骨病运动医学科, 浙江 宁波 315040 |
Department of Joint Surgery and Sports Medicine, the 113 th Hospital of People Liberation Army, Ningbo 315040, Zhejiang, China |
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| 苗帅 |
MIAO Shuai |
解放军第113医院关节骨病运动医学科, 浙江 宁波 315040 |
Department of Joint Surgery and Sports Medicine, the 113 th Hospital of People Liberation Army, Ningbo 315040, Zhejiang, China |
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| 曾磊 |
ZENG Lei |
解放军第113医院关节骨病运动医学科, 浙江 宁波 315040 |
Department of Joint Surgery and Sports Medicine, the 113 th Hospital of People Liberation Army, Ningbo 315040, Zhejiang, China |
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| 戴赛君 |
DAI Sai-jun |
解放军第113医院关节骨病运动医学科, 浙江 宁波 315040 |
Department of Joint Surgery and Sports Medicine, the 113 th Hospital of People Liberation Army, Ningbo 315040, Zhejiang, China |
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| 李梁 |
LI Liang |
解放军第113医院关节骨病运动医学科, 浙江 宁波 315040 |
Department of Joint Surgery and Sports Medicine, the 113 th Hospital of People Liberation Army, Ningbo 315040, Zhejiang, China |
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| 李纯志 |
LI Chun-zhi |
解放军第113医院关节骨病运动医学科, 浙江 宁波 315040 |
Department of Joint Surgery and Sports Medicine, the 113 th Hospital of People Liberation Army, Ningbo 315040, Zhejiang, China |
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| 期刊信息：《中国骨伤》2019年32卷，第6期，第539-543页 |
| DOI：10.3969/j.issn.1003-0034.2019.06.011 |
| 基金项目:全军医药卫生科研基金课题（编号：15MS021）；宁波市体育科学研究课题（编号：795SS1711） |
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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两组：微骨折组33例，男20例，女13例，年龄（28.1±4.2）岁；移植组38例，男26例，女12例，年龄（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），Ahlbäck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62.9±6.8、60.3±7.5提高到术后的77.0±5.4、85.8±5.6（P<0.05）；HSS评分分别由术前81.5±7.6、79.6±8.6改善为88.0±4.7、91.9±4.7（P<0.05）。移植组术后Lysholm评分与HSS评分，均高于微骨折组（P<0.05）。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]:软骨 关节 膝关节 关节成形术 软骨下 骨移植 |
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| Comparison of curative effect between osteochondral mosaic transplantation and micro-fracture in the treatment of knee joint articular cartilage injury |
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Abstract:
Objective:To compare the clinical outcomes of microfracture and autogenous osteochondral mosaic transplantation in the treatment of knee joint cartilage injury.
Methods:A retrospective analysis of 71 patients with articular cartilage defects on the femoral condyles who were by autogenous osteochondral mosaic transplantation or microfracture from February 2011 to February 2016,and these patients were followed up for at least 2 years. According to the sugical procedures,the patients 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 old;in the mosaicplasty group,there were 38 patients,26 males and 12 females,with a mean age of(27.8±3.5) years old. The Lysholm knee score,Hospital for Special Surgery (HSS) knee score and the Ahlbäck 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 preoperatively to 77.0±5.4 and 85.8±5.6 post-operatively,respectively(P<0.05). Mean HSS scores of the microfracture group and the mosaicplasty group improved from 81.5±7.6 and 79.6±8.6 preoperatively to 88.0±4.7 and 91.9±4.7 post-operatively,respectively(P<0.05). The mean Lysholm score and HSS score were significantly higher in the mosaicplasty group than those in the microfracture group at the latest follow-up. One patient in the mosaicplasty group suffered superficial wound infection. During the 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 has better clinical outcome than the microfracture. |
| KEYWORDS:Cartilage articular Knee joint Arthroplasty subchondral Bone transplantation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄承,陆志剀,黄晨,王飞,苗帅,曾磊,戴赛君,李梁,李纯志.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[J].中国骨伤,2019,32(6):539~543 |
| 英文格式: | HUANG Cheng,LU Zhi-kai,HUANG Chen,WANG Fei,MIAO Shuai,ZENG Lei,DAI Sai-jun,LI Liang,LI Chun-zhi.Comparison of curative effect between osteochondral mosaic transplantation and micro-fracture in the treatment of knee joint articular cartilage injury[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(6):539~543 |
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