自体骨软骨移植治疗距骨骨软骨损伤的疗效

目的观察应用自体骨软骨移植对治疗距骨骨软骨损伤的临床疗效.方法选择2010年7月至2016年3月在本院行自体骨软骨移植手术15例距骨骨软骨损伤的患者,比较手术治疗前后踝关节疼痛VAS评分、踝关节功能AOFAS评分、踝关节活动度及膝关节HSS评分的变化.结果 15例患者均获得随访,术后随访>6个月,患者踝关节疼痛VAS评分从术前(5.13±0.915)分降至术后(3.07±0.594)分,差异有统计学意义(P=0.000);AOFAS评分从术前(55.87±2.696)分上升至术后(88.67±2.38)分,差异有统计学意义(P=0.000).踝关节活动度由术前(43.2±3.668)°升高至术后(65.33±5.164)°,差异有统计学意义(P=0.000).膝关节HSS评分术前、术后变化不明显.结论距骨骨软骨损伤应用自体骨软骨移植术治疗效果显著,能明显改善踝关节功能,减轻疼痛,且对供区影响较小,值得推广.

Objective To observe the clinical effect of autologous osteochondral transplantation for osteochondral lesions of the talus. Methods Fifteen patients with talus osteochondral injury underwent autogenous osteochondral transplantation in our hospital from July 2010 to March 2016 were selected to compare the VAS score of ankle pain, AOFAS score of ankle function, ankle mobility and HSS score of knee joint before and after operation. Results All of these 15 patients were followed up and the post-operation follow-up continued more than 6 months. Ankle pain VAS scores decreased from pre-operation(5.13±0.915)to post-operation(3.07±0.594)with the difference highly statistically significant(P=0.000). Ankle function AOFAS scores increased from pre-operation(55.87±2.696)to post-operation(88.67±2.38)with the difference highly statistically significant(P=0.000). The activity of ankle was elevated from pre-operation(43.2±3.668)to post-operation(65.33±5.164)and the difference was statistically significant(P=0.000). While the knee-joint HSS scores showed no obvious change. Conclusion Autologous osteochondral transplantation may has a significant effect on the osteochondral lesions of the talus with dramatically improved function of ankle and pain and small impact on the donor site. It is worth to be generalized.