Osseous Integration after Fresh Osteochondral Allograft Transplantation to the Distal Femur: A Prospective Evaluation Using Computed Tomography
Osseous Integration after Fresh Osteochondral Allograft Transplantation to the Distal Femur: A Prospective Evaluation Using Computed Tomography
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DOI：
10.1177/1947603511410418
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发表时间：
2011-10-01
期刊：
影响因子：
2.8
通讯作者：
Crawford, Dennis C.
中科院分区：
文献类型：
--
作者：
Brown, Dawson;Shirzad, Khalid;Crawford, Dennis C.
目的：新鲜骨软骨同种异体移植（OCA）是股骨远端骨-软骨复合物损伤患者的一种越来越可行的选择。本研究前瞻性地评估了新鲜OCA与股骨髁单个或多个圆柱形移植物的骨整合和早期临床结果。设计：采用OCA治疗股骨远端国际软骨修复协会（ICRS） 4级缺损患者。在术前和术后6、12和24个月收集结果测量数据。6个月时的计算机断层扫描（CT）用于评估局部骨融合程度。结果：报告了34例患者，平均年龄34.5岁（范围15-61岁），因局灶性骨关节炎、夹层性骨软骨炎和缺血性坏死，平均股骨骨软骨病变5.7 cm(2)（范围1.5-15.0）。有统计学意义（P < 0.05）的2年预后评分平均改善包括膝关节损伤和骨关节炎预后评分（oos）疼痛、运动和娱乐、生活质量和国际膝关节文献委员会（IKDC）。CT成像显示植入直接负重区移植物的植入率为bbb75 % （20/26）
Objective: Fresh osteochondral allograft transplantation (OCA) is an increasingly available option for patients with damage to the bone-cartilage complex of the distal femur. This study prospectively assesses osseous integration and early clinical results following fresh OCA with single or multiple cylindrical grafts to the femoral condyle. Design: Patients with grade 4 International Cartilage Repair Society (ICRS) defects of the distal femur were treated with OCA. Outcome measures were collected preoperatively and postoperatively at 6, 12, and 24 months. Computed tomography (CT) scans obtained at 6 months were used to assess degree of osseous incorporation regionally. Results: Thirty-four patients, with a mean age of 34.5 years (range, 15-61), with a mean femoral osteochondral lesion of 5.7 cm(2) (range, 1.5-15.0) due to focal osteoarthritis, osteochondritis dissecans, and avascular necrosis, are reported. Statistically significant (P < 0.05) mean improvement in outcome scores at 2 years included Knee Injury and Osteoarthritis Outcomes Score (KOOS) pain, sports and recreation, quality of life, and International Knee Documentation Committee (IKDC). CT imaging indicated grafts implanted to direct weightbearing regions had >75% incorporation (20/26 grafts) compared to