治疗骨软骨损伤的镶嵌成形技术

Emil Simeonov
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摘要

引言关节软骨损伤在普通人群中是一个相当常见的问题,尤其是在年轻人和运动人群中。这些损伤如不及时治疗,将导致创伤后骨关节炎。考虑到骨关节炎的高发病率和社会经济负担,骨软骨损伤的治疗给外科医生带来了独特的挑战。材料/方法:我们提出了几个假设,以探究是否可以使用镶嵌成形术来成功治疗骨软骨病变。此外,还对开放式小型手术和关节镜手术进行了测试,以确定它们是否能达到与镶嵌成形术相同的效果。这项研究从普通人群中抽取了45名患者,其中13名患者接受了开放式镶嵌成形术,17名患者接受了迷你开放式镶嵌成形术,15名患者接受了关节镜镶嵌成形术。每次就诊时都会使用 Lysholm 和 VAS 量表对膝关节软骨重建情况进行评估。此外,还进行了组织学检查。结果:手术前和手术后的 Lysholm 评分以及手术前和手术后的 VAS 评分之间存在明显差异。此外,组织学分析证实骨软骨自体移植物移植成功,并与受者膝关节融合。结论:研究表明,多种镶嵌成形技术可用于关节软骨重建。此外,组织学检查进一步证实了自体移植物的可行性。
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MOSAICPLASTY TECHNIQUES IN THE TREATMENT OF OSTEOCHONDRAL INJURIES
Introduction: Articular cartilage damage is quite a common problem within the general population, especially in the younger and more athletic populations. These defects, if left untreated, would lead to post-traumatic osteoarthritis. Taking into consideration the high frequency and socioeconomic burden of osteoarthritis, the treatment of osteochondral lesions presents a unique challenge for surgeons. Materials/Methods: Several hypotheses were formulated to discover whether mosaicplasty could be used in order to successfully treat osteochondral lesions. Furthermore, open mini and arthroscopic surgery were tested to determine whether they could achieve the same result as mosaicplasty. A sample of 45 patients from the general population volunteered for the study, of whom 13 patients underwent open mosaicplasty, 17 mini-open and 15 patients arthroscopic mosaicplasty. Assessment of the knee articular cartilage reconstruction was done during each visit, utilising Lysholm and the VAS scale. A histological examination was also performed. Results: A significant difference was observed between pre- and post-surgical Lysholm score, as well as between pre- and post-surgical VAS score. Additionally, histological analysis confirmed the success of osteochondral autograft transfer and integration into the recipient's knee. Conclusion: The study demonstrated that several mosaicplasty techniques could be used in articular cartilage reconstruction. Moreover, the histological examination further confirmed the viability of the autograft.
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