論文

査読有り
2018年3月1日

Resection-Induced Leveling of Elevated Plug Cartilage in Osteochondral Autologous Transplantation of the Knee Achieves Acceptable Clinical Results

American Journal of Sports Medicine
  • Kohei Nishitani
  • ,
  • Yasuaki Nakagawa
  • ,
  • Shinichiro Nakamura
  • ,
  • Shogo Mukai
  • ,
  • Shinichi Kuriyama
  • ,
  • Shuichi Matsuda

46
3
開始ページ
617
終了ページ
622
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1177/0363546517739614
出版者・発行元
SAGE Publications Inc.

Background: Plug protuberance occasionally occurs in osteochondral autologous transplantation (OAT). The incongruity of plugs results in poor clinical outcomes, especially in cases of protuberance. However, a surgical procedure to deal with this problem has not been reported. Purpose/Hypothesis: The purpose was to evaluate the efficacy and safety of cartilage resection of elevated plugs, with the hypothesis that patients whose elevated plugs were resected and leveled would achieve clinical outcomes equivalent to those of patients with flush plugs. Study Design: Cohort study
Level of evidence, 3. Methods: Cases (group P) included 22 patients who underwent OAT of the knee and whose plugs showed protuberance greater than 1 mm that was resected with a scalpel to obtain smooth congruity, while controls (group C) included 22 background-matched patients who did not require plug resection. The International Knee Documentation Committee (IKDC) subjective score, IKDC objective grade, and Japanese Orthopaedic Association score for knee osteoarthritis (JOA knee score) were used preoperatively and at the final follow-up (mean ± SD, 49.3 ± 18.1 months). International Cartilage Repair Society (ICRS) Cartilage Repair Assessment was used to evaluate lesion healing during the second-look arthroscopy. Results: IKDC subjective scores of group C (82.5 ± 11.8) and group P (82.1± 15.1) showed no difference at the final follow-up. On postoperative IKDC objective grading, 86% of group C and 82% of group P patients were graded as “nearly normal” or better (P =.639). The mean JOA knee scores of group C (90.9 ± 8.9) and group P (90.1 ± 9.5) did not differ significantly (P =.647). Nine second-look arthroscopies were performed in group C versus 8 in group P, and all patients had plugs that were graded as “nearly normal” or better by the ICRS Cartilage Repair Assessment. Larger plugs tended to be used in those patients who required resection. Conclusion: Resection of the elevated plug surface did not negatively affect patient outcomes in the midterm follow-up period.

リンク情報
DOI
https://doi.org/10.1177/0363546517739614
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/29161095
ID情報
  • DOI : 10.1177/0363546517739614
  • ISSN : 1552-3365
  • ISSN : 0363-5465
  • PubMed ID : 29161095
  • SCOPUS ID : 85042866575

エクスポート
BibTeX RIS