关节镜下Microfracture术与Pridie钻孔术修复膝关节软骨全层缺损临床疗效的比较研究  

Clinical outcomes of the full-thickness chondral defects repair in the knee with arthroscopic microfracture and Pridie drilling technique

作　　者：王彦明[1,2] 余家阔[1] 敖英芳[1] 王健全[1] 崔国庆[1] 胡跃林[1] 张继英[1] 傅欣[1] 

机构地区：[1]北京大学第三医院运动医学研究所,100191 [2]北京民航总医院骨科

出　　处：《中华关节外科杂志（电子版）》2010年第6期13-16,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的比较关节镜下Microfracture术与Pridie钻孔术修复膝关节关节软骨全层缺损的临床疗效。方法 2006年1月至2009年12月,本组接受关节镜诊治的膝关节关节软骨全层缺损患者共72例(80膝),随机分为两组:Microfracture术组与Pridie钻孔术组。Microfracture术组(36例,40膝)接受关节镜下Microfracture术治疗;Pridie钻孔术组(36例,40膝)接受关节镜下Pridie钻孔术治疗。两组患者术后随访11～59个月,平均随访时间(39.0±13.7)个月。采用Lysholm膝关节功能评分作为膝关节功能的判定标准对两组患者手术疗效进行比较。结果 Microfracture术组患者术后总有效率为94.5%,其中疗效优23例(63.9%),疗效良11例(30.6%),疗效差2例(5.5%)。平均Lysholm评分从(38.1±14.9)分提高到(89.4±12.3)分。手术前后疗效比较有统计学差异(P<0.01)。Pridie钻孔术组修复膝关节关节软骨全层缺损总有效率为86.1%,其中疗效优15例(41.7%),疗效良16例(44.4%),疗效差5例(13.9%)。平均Lysholm评分由术前的(36.7±12.8)分提高到(80.2±9.5)分。手术前后疗效比较有统计学差异(P<0.01)。Microfracture术组与Pridie钻孔术组两组患者的临床疗效比较无统计学差异(P>0.05)。结论关节镜下Microfracture术与Pridie钻孔术修复膝关节关节软骨全层缺损的临床疗效初步比较无统计学差异,但Microfracture术组的患者有表现出较好术后疗效的趋势。Objective To compare the clinical effects of arthroscopic microfracture with Pridie drilling for the repair of fullthickness chondral defects in the knee.Methods 72 patients（80 knees） who suffered from full-thickness articular cartilage defects were randomly divided into microfracture group and Pridie drilling group from January 2006 to December 2009.36 cases（40 knees） in the microfracture group had received the treatment with arthroscopic microfracture technique,the other 36 cases（40 knees） in the Pridie drilling group had received the treatment with arthroscopic Pridie drilling technique.All the patients were followed up for an average of（39.0 ± 13.7） months（range：11-59 months）.Lysholm score was used for evaluation before and after the operation for both groups.Results Both procedures resulted in a significant improvement compared to the situation before the operation.In microfracture group,23 cases showed excellent result（63.9%）,11 cases were good result（30.6%）,and two cases had bad result（5.5%）.The total effective rate of clinical outcome was94.5%.The mean Lysholm score improved from（38.1 ±14.9） to（89.4 ± 12.3）（P 0.01）.There was significant improvement of knee function scores between preoperation and postoperation group（P 0.01）.In Pridie drilling group,15 cases showed excellent result（41.7%）,16 cases were good result（44.4%）,and five cases had bad result（13.9%）.The total effective rate of clinical outcome was 86.1%.Lysholm score improved from（36.7 ± 12.8） to（80.2 ±9.5）（P0.01）.Significant knee function scores improvement was also found postoperatively in this group（P0.01）.No significant difference was noticed between microfracture and Pridie drilling for treatment of full-thickness articular chondral defects in the knee（P 0.05）.Conclusions Both microfracture and Pridie drilling techniques had good clinical results in treatment of the fullthickness chondral defects in the knee.There was no significant difference in the clinica

关 键 词：MICROFRACTURE Pridie钻孔 软骨 关节 软骨修复 关节镜 

分 类 号：R687.4[医药卫生—骨科学]