关节镜下微骨折术联合富集自体骨髓单核细胞移植治疗膝关节自发性骨坏死的疗效观察  

Efficacy of arthroscopic microfracture combined with enriched autologous bone marrow monocyte transplantation in treatment of spontaneous osteonecrosis of knee

作　　者：尚雷[1] 冯仕明[1] 裴非凡 郭通亚 刘光旺[1] 马超[1] 许永[1] SHANG Lei;FENG Shiming;PEI Feifan;GUO Tongya;LIU Guangwang;MA Chao;XU Yong(Department of Bone and Joint Surgery,Xuzhou Central Hospital,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州市中心医院骨关节外科,江苏221000

出　　处：《中国骨与关节损伤杂志》2025年第2期141-144,共4页Chinese Journal of Bone and Joint Injury

基　　金：江苏省卫生健康委员会面上项目(M2022048)。

摘　　要：目的观察关节镜下微骨折术联合富集自体骨髓单核细胞移植治疗膝关节自发性骨坏死(Spontaneous osteonecrosis of the knee,SONK)的临床疗效。方法纳入自2018-01—2023-01手术治疗的35例SONK,观察组18例采用关节镜下微骨折术联合富集自体骨髓单核细胞移植治疗,对照组17例单纯采用关节镜下微骨折术治疗。比较两组术后6个月疼痛VAS评分、膝关节功能HSS评分、MRI图像上同一部位软骨缺损面积,以及组间并发症发生率。结果35例均获得随访,随访时间6~36个月,平均12.8个月。观察组出现3例并发症,对照组出现2例并发症,组间并发症发生率差异无统计学意义(P>0.05)。观察组和对照组术后6个月疼痛VAS评分、膝关节功能HSS评分较术前明显改善,MRI图像上软骨缺损面积较术前明显减小,差异有统计学意义(P<0.05)。观察组术后6个月疼痛VAS评分低于对照组,膝关节功能HSS评分高于对照组,MRI图像上软骨缺损面积较对照组缩小,差异有统计学意义(P<0.05)。结论关节镜下微骨折术联合富集自体骨髓单核细胞移植治疗SONK可以明显减轻患者膝关节疼痛症状,改善膝关节功能,并发症发生率低,是一种安全、有效的手术治疗方法。ObjectiveTo observe the clinical efficacy of arthroscopic microfracture combined with enriched autologous bone marrow mononuclear cell transplantation in the treatment of spontaneous osteonecrosis of the knee(SONK).MethodsA total of 35 cases of SONK treated surgically from January 2018 to January 2023 were included.The observation group consisted of 18cases treated with arthroscopic microfracture combined with enriched autologous bone marrow mononuclear cell transplantation,while the control group comprised 17 cases treated solely with arthroscopic microfracture.The postoperative pain VAS score,knee function HSS score,the area of cartilage defect in the same region on MRI images,and the incidence of complications at 6months after operation between the two groups were compared.ResultsAll 35 cases were followed up for 6 to 36 months,with an average of 12.8 months.The observation group experienced 3 complications,while the control group had 2 complications,with no statistically significant difference in the incidence of complications between the groups(P>0.05).Both the observation and control groups showed significant improvements in postoperative pain VAS scores and knee function HSS scores at 6months after operation compared to preoperative values,and the area of cartilage defect on MRI images significantly reduced compared to preoperative measurements,with statistically significant differences(P<0.05).At 6 months postoperatively,the observation group had lower pain VAS scores,higher HSS scores,and a smaller area of cartilage defect on MRI compared to the control group,with statistically significant differences(P<0.05).ConclusionArthroscopic microfracture combined with enriched autologous bone marrow mononuclear cell transplantation for the treatment of SONK can significantly alleviate knee pain and improve knee function with a low incidence of complications,making it a safe and effective surgical treatment method.

关 键 词：膝关节自发性骨坏死 关节镜 微骨折术 骨髓单核细胞 自体细胞移植 

分 类 号：R687.3[医药卫生—骨科学]