微骨折术与自体骨软骨移植治疗距骨骨软骨损伤的早期临床结果  

Microfracture and autologous osteochondral transplantation for the treatment of osteochondral lesions of the talus:early clinical results

作　　者：郑海龙[1] 魏立[1] 唐强[1] ZHENG Hai - long WEI Li TANG Qiang(Yibin First People＇s Hospital, Yibin 644000, Chin)

机构地区：[1]宜宾市第一人民医院,四川644000

出　　处：《创伤外科杂志》2017年第8期595-597,602,共4页Journal of Traumatic Surgery

摘　　要：目的对比分析关节镜结合微骨折术与自体骨软骨移植术治疗距骨骨软骨损伤的疗效。方法回顾分析2013年1月-2015年4月宜宾市第一人民医院收治的80例距骨骨软骨损伤患者的治疗情况,根据治疗方法不同分为A组(采取踝关节镜下微骨折术治疗)和B组(采取踝关节镜下自体软骨移植术治疗),每组40例。比较两组患者的踝关节功能、疼痛评分变化,对比分析治疗效果。结果两组患者术后2、6个月疼痛和踝关节功能评分与术前比较,差异均有统计学意义(P<0.05);两组的疼痛评分比较,差异无统计学意义P>0.05);B组的治疗有效率(97.5%)与A组(80.0%)比较,差异有统计学意义(P<0.05);两组患者均未出现相关并发症。结论关节镜结合微骨折术和自体骨软骨移植术治疗距骨软骨损伤均具有较好的临床疗效,均能改善患者的踝关节功能,缓解患者的疼痛症状,并且均有较高的安全性。自体骨软骨移植相较于微骨折术的治疗有效率更佳,值得临床推广。Objective To evaluate the efficiency of arthroscopic microfracture and autologous osteochondral transplantation in the treatment of osteochondral lesion of the talus. Methods Totally 80 cases of talar osteochon- dral injury from Jan. 2013 to Apr. 2015 were selected. Forty cases in group A were treated with ankle arthroscopy and 40 cases in group B were treated with autologous osteochondral transplantation. Their clinical data was analyzed retrospectively. The ankle function, VAS scores and clinical effect were compared between the two groups. Results VAS and AOFAS score in the two groups were significantly improved compared with preoperatively { P 〈 0.05 }. There was no significant difference in the scores of VAS and AOFAS between the 2 groups （ P 〈 O. 05 ）. The excel- lent rate of group B at the end of treatment was 97.5% , which was significantly higher than group A （ 80.0% ） , P 〈 0.05. No complication occurred. Conclusion Arthroscopy and autologous osteochondral transplantation for treatment of talar cartilage injury has good curative effect, can improve patients＇ foot function and relieve their pain with hizh safety. The treatment of autolozous osteochondral transplantation is more efficient.

关 键 词：距骨骨软骨损伤 关节镜 微骨折术 自体骨 移植 

分 类 号：R683.42[医药卫生—骨科学]