Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints -: Ten years of experimental and clinical experience
Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints -: Ten years of experimental and clinical experience
复制标题
DOI：
10.2106/00004623-200300002-00004
复制
发表时间：
2003-01-01
影响因子：
5.3
通讯作者：
Füles, P
中科院分区：
文献类型：
--
作者：
Hangody, L;Füles, P
背景：成功治疗负重面的软骨和骨软骨缺损对骨科医生来说是一个挑战。自体骨软骨移植是一种可用于在缺损区域形成透明或透明样修复的方法。本文描述了自体骨软骨镶嵌成形术10年临床经验的结果。方法：临床评分、影像学技术、关节镜检查、活检样本的组织学检查和软骨硬度测量用于评估831例接受镶嵌成形术的患者的临床结果和移植软骨的质量。结果：根据这些研究，92%的股骨髁置换患者，87%的胫骨表面置换患者，79%的髌骨和/或股骨柄镶嵌成形术患者，94%的患者接受了距骨手术。使用Bandi评分评估的长期供区紊乱显示，镶嵌成形术后患者的发病率为3%。在83例接受关节镜随访的患者中，69例显示了一致的滑动表面，移植透明软骨存活的组织学证据，以及供区的纤维软骨填充。手术的并发症包括四个深部感染和36个痛苦的术后hemarthrose.Conclusions：这些有前途的结果和其他类似研究的基础上，自体骨软骨镶嵌成形术似乎是一种替代治疗的小型和中型的局灶性软骨和骨软骨缺损的负重表面的膝盖和其他负重滑膜关节。
Background: The successful treatment of chondral and osteochondral defects of the weight-bearing surfaces is a challenge for orthopaedic surgeons. Autologous osteochondral transplantation is one method that can be used to create hyaline or hyaline-like repair in the defect area. This paper describes the results after ten years of clinical experience with autologous osteochondral mosaicplasty.Methods: Clinical scores, imaging techniques, arthroscopy, histological examination of biopsy samples, and cartilage stiffness measurements were used to evaluate the clinical outcomes and quality of the, transplanted cartilage in 831 patients undergoing mosaicplasty.Results: According to these investigations, good-to-excel lent results were achieved in 92% of the patients treated with femoral condylar implantations, 87% of those treated with tibial resurfacing, 79% of those treated with patellar and/or trochlear mosaicplasties, and 94% of those treated with talar procedures. Long-term donor-site disturbances, assessed with use of the Bandi score, showed that patients had 3% morbidity after mosaicplasty. Sixty-nine of eighty-three patients who were followed arthroscopically showed congruent gliding surfaces, histological evidence of the survival of the transplanted hyaline cartilage, and fibrocartilage filling of the donor sites. Complications of the surgery included four deep infections and thirty-six painful postoperative hemarthroses.Conclusions: On the basis of these promising results and those of other similar studies, autologous osteochondral mosaicplasty appears to be an alternative for the treatment of small and medium-sized focal chondral and osteochondral defects of the weight-bearing surfaces of the knee and other weight-bearing synovial joints.