中国医学创新2016，Vol.13Issue(35)：1-5,6,6.DOI:10.3969/j.issn.1674-4985.2016.35.001
关节镜辅助下自体髌股关节面骨软骨移植治疗HeppleⅢ~Ⅴ期距骨骨软骨损伤
Arthroscopy Assisted Osteochondral Autologous Transplantation Harvested from Lateral Femoral Condyle of Knee for the Treatment of HeppleⅢ-Ⅴ Osteochondrallesions of Talus
摘要
Abstract
Objective:To investigate the efficacy of arthroscopy assisted osteochondral autologous transplantation harvested from lateral femoral condyle of the knee for the treatment of osteochondral lesions of talus. Method:A retrospective analysis of inclusive 11 cases of Hepple Ⅲ-Ⅴ osteochondral lesions of the talus patients, who accepted arthroscopy assisted osteochondral autologous transplantation harvested from lateral femoral condyle of the knee treatment from 2011 March to 2014 May,including 6 males and 5 females with all average age was 33 years old(range from 16 to 43 years old).3 left ankles and 8 right ankles were affected Hepple Ⅲ stage in 6 cases,Ⅳ stage in 3 cases,Ⅴ stage in 2 cases.7 patients had a history of trauma.Definite diagnosis to operation time ranged from 3 days to 4 months,with an average of 23.36 d. The bad side ankle pain visual analogue scale(visual analogous scale,VAS) before operation was (7.18±1.17)score,preoperative AOFAS (American orthopaedic foot and ankle Society,AOFAS) score was (61.64±14.00)score,and Lysholm score for supported side knee joint before surgery was (94.45±3.39)score.Result:Operations were all successfully completed and the incision healed well in all cases.11 cases got follow up from 6 to 14 months(average 10 months).Postoperative follow-up(magnetic resonance imaging,MRI) showed osteochondral bolts and bone beds healed well,the cartilage surface was in good shape,and the healing time of bone and cartilage were 8-13 weeks,the average were 10.55 weeks.At the last follow-up,VAS score was (1.73±1.02)score,and compared with before operation there was statistical significance(t=10.59,P=0.000).AOFAS score was (91.27±6.60)score,was significantly increased compared with before operation(t=-6.18,P=0.000),while Lysholm score has no significant difference compared with before operation(93.27±3.50,t=2.20,P=0.070).No cartilage peeling off and osteotomy unhealing,no nerve and vascular injury,no ankle adhesion and knee joint pain,or any orther complications were found in follow up.Conclusion:Arthroscopy assisted osteochondral autologous transplantation harvested from lateral femoral condyle of the knee for the treatment of osteochondral lesions of the talus of talarosteochondral is a good effect,less trauma,quicker recovery,safe and reliable treatment.关键词
骨软骨移植/距骨/骨软骨损伤/关节镜Key words
Osteochondral transplantation/Talus/Osteochondral injury/Arthroscopy引用本文复制引用
席智杰,王斌,梁倩倩,米琨,俸志斌..关节镜辅助下自体髌股关节面骨软骨移植治疗HeppleⅢ~Ⅴ期距骨骨软骨损伤[J].中国医学创新,2016,13(35):1-5,6,6.基金项目
国家自然基金项目（H2710）；国家自然基金青年基金项目（81403417）；全国优秀博士学位论文作者专项基金项目（201276）；上海市卫生和计划生育委员会课题 （）
