距骨骨软骨损伤采用踝关节镜下微骨折手术及自体骨软骨移植术的疗效对比

Clinical Comparison of Arthroscopic Micro-Fracture Surgery and Autologous Osteochondral Transplantation in the Treatment of Talus Cartilage Injury

目的:对比分析踝关节镜下微骨折手术和自体骨软骨移植术治疗距骨骨软骨损伤的临床疗效及影响。方法:将某院收治的112例距骨骨软骨损伤患者,随机分为微骨折手术组和自体骨软骨移植术组,各56例,比较两组患者的前后踝关节VAS、AOFAS踝-后足评分、临床疗效和复发情况。结果:两组治疗前VAS评分、AOFAS踝关节评分、并发症发生率对比差异无统计学意义(P>0.05);治疗后,两组患者的踝关节VAS均有所下降,AOFAS踝关节评分均升高,且微骨折术组踝关节VAS高于移植术组,但AOFAS踝关节评分较低,差异均有统计学意义(P<0.05)。微骨折术组治疗总有效率明显高于移植术组。结论:踝关节镜下微骨折术相对自体骨软骨移植术治疗距骨骨软骨损伤,疗效显著,值得在临床借鉴。

Objective:To compare and evaluate the clinical effects of arthroscopic micro-fracture surgery and autologous osteochondral transplantation in the treatment of talus cartilage injury. Methods:112 patients with talus cartilage injury were randomly divided into the micro-fracture surgery group and autologous osteochondral transplantation group, with 56 cases in each group. The VAS scores, AOFAS ankle-back foot score, clinical efficacy and patients’ relapse were compared between the two groups. Results: There was no statistically significant difference in VAS score, AOFAS ankle score and complication rate between the two groups before treatment(P>0.05). After treatment, the ankle VAS in both groups decreased and the AOFAS ankle score increased, and the ankle VAS in the micro-fracture surgery group was higher than that in the autologous osteochondral transplantation group, but the AOFAS ankle score was lower, with statistically significant differences(P<0.05). The total treatment efficiency of the micro-fracture surgery group was significantly higher than that of the autologous osteochondral transplantation group. Conclusion:Compared with autologous osteochondral transplantation, the treatment of talus cartilage injury by arthroscopic micro-fracture surgery has remarkable curative effect, which is worthy of clinical reference.