A comparison of open versus arthroscopic harvesting of osteochondral autografts
A comparison of open versus arthroscopic harvesting of osteochondral autografts
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DOI：
10.1016/j.knee.2009.02.010
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发表时间：
2009-12-01
期刊：
影响因子：
1.9
通讯作者：
McGuigan, Francis X.
中科院分区：
文献类型：
--
作者：
Keeling, John J.;Gwinn, David E.;McGuigan, Francis X.
自体骨软骨移植是一种治疗创伤性和退行性软骨病变的技术。软骨帽垂直于移植物长轴的移植物是理想的，因为它既可以恢复软骨潮痕，又可以最大限度地减少接受部位的关节脱臼。本研究确定骨软骨采集技术（关节镜与微型开放）或供体部位位置是否影响合适的移植物采集。使用 7 毫米 OATS 凿子从四个供体部位（外侧髁上嵴、外侧股骨髁、外侧髁间切迹和内侧股骨髁）在 16 具尸体膝盖中采集了 128 个骨软骨移植物。同样采用了微型开放式和关节镜采集技术。使用射线照相方法来分析移植物的垂直度。进行了统计分析，比较了基于技术和供体部位位置的移植物适用性。无论使用何种技术或供体部位位置如何，移植物适用性均无统计学显着差异（p>0.05）。 69% 的关节镜手术和 56% 的微型开放式移植物收获被认为是合适的，其软骨帽和移植物轴角会产生小于 1 毫米的关节不协调。当软骨下骨塞长轴与软骨界面之间的角度大于74度时会导致不协调。无论使用何种技术或供体部位，从膝盖采集的骨软骨移植物的质量都没有差异。骨软骨移植物直径应保持在或小于 7 毫米，因为随着凿子尺寸的增加，不可接受的移植物的比例很高。由 Elsevier B.V. 出版
Osteochondral autograft transfer is a technique for treatment of traumatic and degenerative cartilage lesions. A graft in which the cartilage cap is oriented perpendicular to the long axis of the graft is ideal because it can both restore the cartilage tidemark and minimize articular step-off at the recipient site. This study determines if osteochondral harvest technique (arthroscopic versus mini-open) or donor site location affects suitable graft harvest. One hundred and twenty eight osteochondral grafts were harvested in 16 cadaver knees utilizing a 7 mm OATS chisel from four donor sites: lateral supracondylar ridge, lateral femoral condyle, lateral intercondylar notch and medial femoral condyle. Mini-open and arthroscopic harvesting techniques were equally employed. Radiographic methods were used to analyze graft perpendicularity. Statistical analysis comparing graft suitability based on technique and donor site location was performed. There were no statistically significant differences (p>0.05) in graft suitability regardless of the technique used or donor site location. 69% of arthroscopic and 56% of mini-open graft harvest were considered suitable, possessing a cartilage cap and graft axis angle that would create less than I mm of articular incongruity. Incongruity results when the angle between the subchondral bone plug long axis and cartilage interface is greater than 74 degrees. There is no difference in the quality of osteochondral grafts harvested from the knee regardless of technique or donor site used. Osteochondral graft diameter should be kept at or less than 7 mm because of the high percentage of unacceptable grafts with increasing chisel sizes. Published by Elsevier B.V.