自体骨软骨移植术应用于HeppleⅤ型距骨骨软骨损伤患者的效果及对关节功能的影响  

Effect of Osteochondral Autograft Transplantation in Patients with HeppleⅤType Osteochondral Lesion of the Talus and Its Influence on Joint Function

作　　者：王鹏飞 牛晓彤 李方凯 WANG Pengfei;NIU Xiaotong;LI Fangkai(Department of Hand and Foot Microsurgery,Shandong Guoxin Yiyang Group Zaozhuang Central Hospital,Zaozhuang 277000,China;不详)

机构地区：[1]山东国欣颐养集团枣庄中心医院手足显微外科,山东枣庄277000

出　　处：《中国医学创新》2024年第17期55-59,共5页Medical Innovation of China

摘　　要：目的:研究自体骨软骨移植术应用于HeppleⅤ型距骨骨软骨损伤(OLT)患者中的效果及对关节功能的影响。方法:选取山东国欣颐养集团枣庄中心医院2018年2月—2023年2月收治的86例HeppleⅤ型OLT患者开展研究,以电脑编号奇偶数字法分为Ⅰ组(n=43)及Ⅱ组(n=43)。Ⅰ组用自体骨软骨移植术治疗,Ⅱ组用关节镜下微骨折术治疗。对比两组疗效、关节功能、血清生长因子水平及并发症发生情况。结果:Ⅰ组总有效率高于Ⅱ组(95.35%vs 76.74%)(P<0.05);术后3个月,两组关节功能相关指标均较术前明显升高,且Ⅰ组均高于Ⅱ组(P<0.05);术后3个月,两组血管内皮生长因子(vascular endothelial growth factor,VEGF)、血小板衍生生长因子(platele derived growth factor,PDGF)均升高,Ⅰ组均高于Ⅱ组,转化生长因子-β_(1)(transforming growth factor-β_(1),TGF-β_(1))均降低,Ⅰ组低于Ⅱ组(P<0.05);Ⅰ组并发症发生率低于Ⅱ组(4.65%vs 20.93%)(P<0.05)。结论:自体骨软骨移植术应用于HeppleⅤ型OLT患者中,疗效较佳,可明显改善患者关节功能及血清生长因子水平,降低并发症发生风险。Objective:To study the effect of osteochondral autograft transplantation in patients with HeppleⅤtype osteochondral lesion of the talus(OLT)and its influence on joint function.Method:A total of 86 patients with HeppleⅤtype OLT admitted to Shandong Guoxin Yiyang Group Zaozhuang Central Hospital from February 2018 to February 2023 were selected for this study.They were divided into groupⅠ(n=43)and groupⅡ(n=43)by computer numbering odd-even number method.GroupⅠwas treated with osteochondral autograft transplantation,groupⅡwas treated with arthroscopic microfracture surgery.The efficacy,joint function,serum growth factors levels and complications were compared between the two groups.Result:The total effective rate of groupⅠwas higher than that of groupⅡ(95.35%vs 76.74%)(P<0.05).3 months after surgery,the relevant indexes of joint function in both groups were significantly higher than those before surgery,and those in groupⅠwere higher than those in groupⅡ(P<0.05).3 months after surgery,the vascular endothelial growth factor(VEGF)and platele derived growth factor(PDGF)were increased in both groups,those in groupⅠwere higher than those in groupⅡ,transforming growth factor-β_(1)(TGF-β_(1))was decreased,and that in groupⅠwas lower than that in groupⅡ(P<0.05).The incidence of complications in groupⅠwas lower than that in groupⅡ(4.65%vs 20.93%)(P<0.05).Conclusion:Osteochondral autograft transplantation is effective in patients with HeppleⅤtype OLT,which can significantly improve joint function and serum growth factors levels,and reduce the risk of complications.

关 键 词：距骨骨软骨损伤 自体骨软骨移植 关节镜微骨折术 关节功能 生长因子 

分 类 号：R687.3[医药卫生—骨科学]