CAJ | 학술논문

目的：评价同侧股骨髁内侧髌股关节面自体骨软骨移植治疗距骨骨软骨损伤的临床疗效。方法选择从2010年3月至2012年12月在我院就诊的20例距骨骨软骨损伤患者，主要损伤病因包括创伤后软骨缺损13例，距骨剥脱性骨软骨炎3例，局灶性骨关节炎1例，其他3例；Stephen Ⅲ型6例，Ⅳ型11例，Ⅴ型3例。所有患者均采用同侧股骨髁内侧髌股关节面自体骨软骨移植治疗距骨骨软骨损伤。随访患者12个月，观察患者治疗前后踝关节的疼痛情况，踝关节活动范围的改善情况，踝关节的评分比较及同侧膝关节的功能评分情况。踝关节的疼痛情况采用视觉模拟评分进行评价，膝关节功能评分参照 Harris 的关节功能评分标准，踝关节功能的评分采用美国足踝外科医师协会评分细则。结果所有患者术后均获得随访，术后患者踝关节的VAS疼痛评分明显下降，差异有统计学意义（ t ＝25.6629，P ＝0.0000），而同侧膝关节的功能评分改变与治疗前比较差异无统计学意义（χ2＝0.3053，P ＝0.7618），术后踝关节的活动范围及踝关节功能均有明显改善，差异均有统计学意义（ P ＜0.05）。结论利用同侧股骨髁内侧髌股关节面自体骨软骨移植治疗距骨骨软骨损伤临床疗效显著，可以很好的改善踝关节功能。
목적：평개동측고골과내측빈고관절면자체골연골이식치료거골골연골손상적림상료효。방법선택종2010년3월지2012년12월재아원취진적20례거골골연골손상환자，주요손상병인포괄창상후연골결손13례，거골박탈성골연골염3례，국조성골관절염1례，기타3례；Stephen Ⅲ형6례，Ⅳ형11례，Ⅴ형3례。소유환자균채용동측고골과내측빈고관절면자체골연골이식치료거골골연골손상。수방환자12개월，관찰환자치료전후과관절적동통정황，과관절활동범위적개선정황，과관절적평분비교급동측슬관절적공능평분정황。과관절적동통정황채용시각모의평분진행평개，슬관절공능평분삼조 Harris 적관절공능평분표준，과관절공능적평분채용미국족과외과의사협회평분세칙。결과소유환자술후균획득수방，술후환자과관절적VAS동통평분명현하강，차이유통계학의의（ t ＝25.6629，P ＝0.0000），이동측슬관절적공능평분개변여치료전비교차이무통계학의의（χ2＝0.3053，P ＝0.7618），술후과관절적활동범위급과관절공능균유명현개선，차이균유통계학의의（ P ＜0.05）。결론이용동측고골과내측빈고관절면자체골연골이식치료거골골연골손상림상료효현저，가이흔호적개선과관절공능。
Objective To explore the clinical value of the ipsilateral medial femoral condyle of the patellofemoral joint surface for autologous osteochondral transplantation therapy to the talus bone cartilage injury,and to analyze its clinical applica_bility. Methods 20 cases of talar osteochondral injury patients were selected from March 2010 to December 2012 in our hos_pital for treatment. There were 13 cases of post_traumatic cartilage defect,3 cases of osteochondritis dissecans of the talus,1 case of focal osteoarthritis,three other cases. There were 6 cases of Stephon Ⅲ,11 cases of Stephon Ⅳ,3 cases of Stephon Ⅴ. We used the ipsilateral medial femoral condyle of the patellofemoral joint surface autologous osteochondral transplantation in the treatment of talar osteochondral injuries. Patients were followed up for 12 months,and observed the ankle pain conditions in patients,ankle range of activities to improve the situation,the ankle scores and ipsilateral knee function score situation before and after treatment. Ankle pain scores were using the VAS,and knee function score referring Harris,ankle function score using AOFAS. Results Postoperative ankle VAS pain scores decreased significantly,and the difference was statistically significant(t= 25. 662 9,P = 0. 000 0),while the change of the ipsilateral knee function score was no significant difference(χ2 = 0. 305 3, P = 0. 761 8),postoperative the range of the ankle joint and ankle joint function were significantly improved,the differences were statistically significant(P < 0. 05). Conclusion The use of the ipsilateral medial femoral condyle of the patellofemoral joint surface for autologous osteochondral transplantation therapy to the talus bone cartilage injury can be a good treatment and mitigation knee function.