微骨折术治疗距骨骨软骨损伤在不同MRI分期患者中的疗效对比

The Analysis of the Efficacy of Ankle Arthroscopic Microfracture in the Treatment of Osteochondral Lesions of the Talus in Different MRI Classifications

目的探讨踝关节镜下微骨折术对于不同MRI分期距骨骨软骨损伤患者的临床治疗效果。方法48例应用踝关节镜下微骨折术治疗距骨软骨损伤的患者,根据MRI表现分级分成4组,术后随访了解踝关节功能恢复与疼痛缓解情况,比较各分组间疗效差异。结果48例平均随访23.7月,对于MRI分级Ⅱ°,Ⅲ°,Ⅳ°,Ⅴ°损伤患者,微骨折术均能带来良好的功能结果(P<0.05);术后AOFAS功能评分总优良率达40例(83.33%),其中Ⅱ°13(100%),Ⅲ°16(100%)远高于Ⅳ°7(63.64%),Ⅴ°4(50%);AOFAS评分改善在各组之间差异不显著(P>0.05),VAS评分改善在各组之间具有明显统计学差异(P<0.05),并且Ⅱ°和Ⅲ°损伤患者VAS评分改善明显优于Ⅳ°和Ⅴ°损伤患者(P<0.05)。结论踝关节镜下微骨折术对不同MRI分期距骨骨软骨损伤的临床治疗有差异,Ⅱ°和Ⅲ°损伤患者疼痛缓解与术后功能明显优于Ⅳ°和Ⅴ°损伤患者。

Objective To explore the clinical effects of ankle arthroscopic microfracture used in different MRI classifications of osteochondral lesions of the talus.Methods 48 cases with osteochondral lesions of the talus and treated with microfracture under the ankle arthroscopy were divided into 4 groups according to MRI classification.The functional recovery and pain relief of ankle joint were observed after the follow-up,and the curative effects of each group were compared.Results The average follow-up of 48 cases was 23.7 months.For MRI gradeⅡ°,Ⅲ°,Ⅳ°,Ⅴ°injury patients,microfracture could bring good functional results(P<0.05).The total excellent and good rate of postoperative AOFAS function score was 40 cases(83.33%),of whichⅡ°13(100%)andⅢ°16(100%)were much higher thanⅣ°7(63.64%),Ⅴ°4(50%).There was no significant difference in the improvement of AOFAS score among the four groups(P>0.05).And the improvement of VAS score in patients withⅡ°andⅢ°injuries was significantly better than that in patients withⅣ°andⅤ°injuries(P<0.05).Conclusion The clinical effects of ankle arthroscopic microfracture are different in different MRI classifications of osteochondral lesions of the talus.Pain relief and postoperative function in patients withⅡorⅢgrade are significantly better than those withⅣorⅤgrade.