关节镜下逆行胫骨平台骨软骨自体移植术治疗膝关节软骨损伤的临床效果  

Clinical outcomes of retrograde tibial plateau osteochondral autologous transplantation under arthroscopy for knee chondral injuries

作　　者：黄培朔 刘丹平 夏楠 吴志文 HUANG Peishuo;LIU Danping;XIA Nan;WU Zhiwen(The First Affiliated Hospital of Jinzhou Medical University,Liaoning 121000,China)

机构地区：[1]锦州医科大学第一附属医院骨与关节外一科,辽宁锦州121000

出　　处：《中华骨与关节外科杂志》2024年第10期898-903,共6页Chinese Journal of Bone and Joint Surgery

基　　金：国家自然科学基金(82072477)。

摘　　要：目的:探讨关节镜下逆行胫骨平台自体骨软骨移植术(OAT)治疗膝关节软骨损伤的临床效果。方法:回顾性分析2017年9月至2022年6月于锦州医科大学第一附属医院采用关节镜下逆行胫骨平台OAT治疗的10例膝关节胫骨平台软骨损伤患者的临床资料。通过Lysholm评分评价患者膝功能,通过疼痛视觉模拟评分(VAS)评价患者疼痛情况。比较手术前后患者膝功能及疼痛情况,记录患者术后并发症的发生情况。结果:患者随访时间为12~28个月。术后3个月,患者Lysholm评分高于术前,VAS评分低于术前,差异均有统计学意义(P均<0.05);术后6个月,患者Lysholm评分均高于术前和术后3个月,VAS评分均低于术前和术后3个月,差异均有统计学意义(P均<0.05);术后12个月,患者Lysholm评分均高于术前和术后6个月,VAS评分均低于术前和术后6个月,差异均有统计学意义(P均<0.05)。所有患者术后均无切口及关节内感染、血栓形成、移植物脱出等并发症发生。结论:关节镜下逆行胫骨平台OAT治疗膝关节软骨损伤,在缓解患者疼痛、改善膝关节功能方面效果显著。Objective:To investigate the clinical effectiveness of retrograde tibial plateau osteochondral autologous transplantation surgery(OATS)under arthroscopy for knee chondral injuries.Methods:A retrospective analysis was conducted on the clinical data of 10 patients with knee tibial plateau chondral injuries treated with retrograde tibial plateau OATS under arthroscopy at the First Affiliated Hospital of Jinzhou Medical University from September 2017 to June 2022.The knee function of the patients was evaluated by the Lysholm score and the pain levels were assessed by the visual analogue scale(VAS).The preoperative and postoperative knee functions and pain levels were compared.Postoperative complications were recorded.Results:The patients were followed up for 12 to 28 months.At 3 months post-surgery,the Lysholm score significantly increased,and VAS score significantly decreased from preoperative levels(all P<0.05).At 6 months post-surgery,the Lysholm score was significantly higher than both preoperatively and 3 months postoperatively,with VAS score being lower than preoperative and 3 months postoperatively(all P<0.05).At 12 months post-surgery,the Lysholm score remained significantly higher than that at both pre-and 6 months post-surgery,with VAS scores significantly lower than that at both pre-and 6 months post-surgery(all P<0.05).No postoperative complications such as incisional or intra-articular infection,thrombosis,or graft extrusion were observed.Conclusions:Retrograde tibial plateau OATS under arthroscopy effectively alleviates pain and improves knee joint function in patients with knee chondral injuries,with favorable clinical outcomes,and is recommended for wider clinical application.

关 键 词：软骨损伤 软骨移植 关节镜 胫骨平台 

分 类 号：R687.3[医药卫生—骨科学]