对齐软骨下骨的自体骨软骨移植治疗运动员距骨骨软骨损伤的疗效分析  

Efficacy of subchondral bone plate aligned autologous osteochondral transplantation in the treatment of osteochondral lesion of talus in athletes

作　　者：申成春[1] 黄雷[1] 张峰[1] 俞嘉锫 朱彦昭[1] 贺萍萍[1] Shen Chengchun;Huang Lei;Zhang Feng;Yu Jiaqian;Zhu Yanzhao;He Pingping(Department of Ankle Surgery,Ningbo Sixth Hospital,Ningbo 315040,Zhejiang,China)

机构地区：[1]宁波市第六医院足踝外科,浙江宁波315040

出　　处：《足踝外科电子杂志》2024年第3期6-9,17,共5页Electronic Journal of Foot and Ankle Surgery

基　　金：宁波市医学科技计划项目(2020Y51)。

摘　　要：目的探讨运动员距骨骨软骨损伤的临床特点及对齐软骨下骨自体骨软骨移植治疗的临床效果。方法回顾性分析2019年6月至2022年6月在宁波市第六医院入院被诊断为距骨骨软骨损伤并接受对齐软骨下骨的自体骨软骨移植手术治疗的23例患者的临床资料,比较本组病例手术前后的视觉模拟评分法(visual analogue scale,VAS)评分、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)后足评分和健康调查简表(the MOS item short from health survey,SF-36)评分,并对距骨骨软骨损伤的临床特点进行分析。结果本组研究人群均成功行对齐软骨下骨的自体骨软骨移植术,平均随访时间为(39.2±8.4)个月,软骨损伤面积为(1.29±0.24)cm²。根据距骨软骨的分区,1区为3例,3区为1例,4区为17例,6区为2例。与术前比较,术后的VAS评分、AOFAS评分、SF-36评分和踝关节活动度均显著改善(P<0.01)。结论对齐软骨下骨的自体骨软骨移植手术可以帮助距骨骨软骨损伤运动员恢复到伤前竞技水平。二次关节镜检查提示对齐软骨下骨的自体软骨移植后软骨形态及弹性与自体距骨软骨一致。Objective To explore the clinical characteristics of talus cartilage injury in athletes and the clinical effect of subchondral bone plate aligned autologous osteochondral transplantation treatment therapy.Methods A retrospective analysis was conducted on the clinical data of 23 patients admitted to the Sixth Hospital of Ningbo City from June 2019 to June 2022,who were diagnosed with talus osteochondral injury and underwent autologous osteochondral transplantation surgery with aligned subchondral bone.The visual analogue scale(VAS)scores,American Orthopedic Foot and Ankle Society(AOFAS)hind foot scores,and the MOS item short from health survey(SF-36)scores before and after surgery were compared in this group of patients,and the clinical characteristics of talus osteochondral injury were analyzed.Results The study population in this group successfully underwent autologous bone cartilage transplantation with aligned subchondral bone,with an average follow-up time of(39.2±8.4)months and a cartilage injury area of(1.29±0.24)cm².According to the zoning of the talus cartilage,there were 3 cases in zone 1,1 case in zone 3,17 cases in zone 4,and 2 cases in zone 6.Compared with preoperative,postoperative VAS score,AOFAS score,SF-36 score,and ankle joint range of motion were significantly improved(P<0.01).Conclusions subchondral bone plate aligned autologous osteochondral grafting can help athletes with osteochondral lesion of talus return to their preinjury competitive level.Second-look of arthroscopy revealed that the cartilage morphology and elasticity after subchondral bone plate aligned autologous osteochondral grafting is consistent with that of autologous talus cartilage.

关 键 词：距骨骨软骨损伤 自体骨软骨移植 美国足踝外科协会评分 

分 类 号：R681[医药卫生—骨科学]