自体软骨镶嵌移植术治疗膝关节股骨髁软骨缺损23例

The effect of the mosaicplasty with autologous cartilage in the treatment of the cartilaginous lesions of knee joint in 23 cases

目的:评估自体软骨镶嵌移植术治疗膝关节股骨髁软骨缺损临床疗效。方法:23例膝关节股骨髁软骨缺损患者均接受自体软骨镶嵌移植术,并对其Lysholm评分、国际软骨修复学会(ICRS)评级、MRI检查及二次关节镜复查取活检组织学检查,评估其临床疗效。结果:术后6个月的优秀率与术前的差异有统计学意义(P<0.01),ICRS评级较术前明显改善(P<0.01)。3例随访期间出现肿胀和疼痛,接受关节腔抽液及灌洗治疗恢复良好。未发现骨性关节炎、深部感染、血栓栓塞等并发症。结论:自体镶嵌骨移植术治疗股骨髁负重区局限性软骨损伤临床疗效确切,值得临床推广应用。

[Abstract] Objective： To investigate the effects of the mosaicplasty with autologous cartilage in the treatment of the cartilaginous lesions of knee joint. Methods：Twenty-three patients were treated with mosaicplasty with autologous cartilage. The clinical effects in all cases were evaluated by Lysholm score, international cartilage repair society and histopathological examination. Results：The difference of the excellent rate between before operation and 6 months after operation in all patients had statistical significance （ P 〈 0.01 ）. Compare with before operation,the lesion degree was significantly improved（ P 〈 O. O1 ）. The swelling and pain in 3 cases were found during the following up period, which recovered by articular cavity infusion and lavage. The osteoarthritis, deep infection and deep venous thrombosis were not found. Conclusions： The effects of the mosaicplasty with autologous cartilage in the treatment of the cartilaginous lesions of knee joint are good, which is worthy of being widely applied in clinic.