• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Early Postoperative Magnetic Resonance Imaging Findings After Autologous Osteochondral Plug Grafts For Osteochondritis Dissecans of the Humeral Capitellum
【24h】

Early Postoperative Magnetic Resonance Imaging Findings After Autologous Osteochondral Plug Grafts For Osteochondritis Dissecans of the Humeral Capitellum

机译：肱骨前庭骨软骨炎剥离自体骨软骨栓塞术后早期磁共振成像发现

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Objectives: Although good clinical outcomes of autologous osteochondral plug grafts for capitellar osteochondritis dissecans (OCD) have been reported, the timing of return to sports was various and still controversial. The period of graft incorporation and the lesion healing at repair site is important to establish the rehabilitation protocol, however there is little information. The aim of this study was to investigate early postoperative magnetic resonance imaging (MRI) findings and clinical outcomes after autologous osteochondral plug grafts for capitellar OCD. Methods: Fifteen young baseball players with advanced lesions of capitellar OCD underwent a procedure using autologous osteochondral plug grafts and underwent MRI (1.5 T) scan at 3 and 6 months, postoperatively. Their mean age at the time of surgery was 13.5 years (range, 13-15 years). Four lesions were classified as International Cartilage Repair Society (ICRS) OCD III and 11 lesions as OCD IV. The mean size of the lesions (sagittal × coronal) was 16 × 14 mm and the mean surface area was 181 mm2. One to two osteochondral plug grafts, with a mean diameter of 7 mm (range, 6-8 mm), were harvested from the lateral femoral condyle and transplanted to the defects. The mean reconstruction rate was 41% (range, 12%-65%), which was calculated as (total surface area of the grafts × 100%)/ (surface area of the lesion). Patients were allowed to begin throwing after 3 months and to return to sports after 6 months. The mean follow-up was 21 months (range, 12-36 months). The MRI findings were assessed graft incorporation, which was indicated by no T1-low-signal-intensity at the graft and no fluid surrounding the graft on T2-weighted fat-suppression (Figure 1), and the lesion healing according to the scoring system of Henderson (4, complete healing; 16, no healing). MRI were blinded and randomized, and two observers reviewed independently and conferred when they differed. Clinical outcomes were evaluated as elbow pain, Timmerman and Andrews (T&A) scores, and return to baseball. We also analyzed the relationship between complete healing at 6 months and each factor: graft size, lesion size, reconstruction rate. Results: Grafts were incorporated in 11 patients at 3 months and 13 patients (87%) at 6 months, postoperatively (Table 1). Mean Henderson score were 4.6 at 3 months and 4.5 at 6 months, and complete healing was in 9 patients at 3 months and 11 patients (73%) at 6 months. The mean T&A score improved significantly from 141 to 184 (P < .05). Thirteen patients had no elbow pain and one patient had occasional mild throwing pain, and all these patients (93%) returned to a competitive level at 6 months. The remaining one patient whose reconstruction rate was 24% and MRI showed incomplete healing at 6 months was difficult to throw because of elbow pain and underwent revision surgery. There were no relationships between complete healing and graft or lesion size (mean graft size: complete 7.4 mm, incomplete 6.8 mm, P = .16, mean lesion size: complete 166 mm2, incomplete 220 mm2, P = .13). On the other hand, all nine patients whose reconstruction rate was 36% or more were achieved complete healing, whereas two of six patients (33%) less than 36% did (P < .05). Conclusion: These results indicated that our rehabilitation protocol was appropriate for young baseball players after autologous osteochondral plug grafts for capitellar OCD. Although it is not clinically required to reconstruct the entire articular defect, more than 36% of the area should be reconstructed.
机译：目的：尽管已经报道了自体骨软骨栓塞移植术治疗剥离小人骨软骨炎（OCD）的良好临床效果，但恢复运动的时机却仍然存在争议。移植物的合并期和修复部位的病变愈合对于建立康复方案很重要，但是信息很少。这项研究的目的是调查自体骨软骨栓塞移植术后小关节强迫症的早期术后磁共振成像（MRI）结果和临床结果。方法：15名年轻的先天性OCD病变的年轻棒球运动员在术后3个月和6个月使用自体骨软骨植入物进行了手术，并进行了MRI（1.5 T）扫描。他们在手术时的平均年龄为13.5岁（范围13-15岁）。四个病变被分类为国际软骨修复协会（ICRS）OCD III，而11个病变被分类为OCD IV。病变的平均大小（矢状×冠状）为16×14 mm，平均表面积为181 mm2。从股骨外侧con收获平均直径为7毫米（范围为6-8毫米）的一到两个骨软骨塞移植物，并将其移植到缺损处。平均重建率为41％（范围为12％-65％），计算方法为（移植物总表面积×100％）/（病变面积）。 3个月后允许患者开始投掷，6个月后恢复运动。平均随访时间为21个月（范围12-36个月）。 MRI检查结果评估了移植物的掺入情况，这表明移植物上没有T1低信号强度，并且在T2加权脂肪抑制下没有液体围绕移植物（图1），并且根据评分系统病变愈合（4，完全治愈; 16，没有治愈）。 MRI是盲目的和随机的，并且两名观察员独立进行了检查，并在分歧时进行了讨论。临床结果以肘部疼痛，蒂默曼和安德鲁斯（T＆A）得分进行评估，然后返回棒球。我们还分析了6个月完全愈合与每个因素之间的关系：移植物大小，病变大小，重建率。结果：术后3个月有11例患者接受了移植，术后6个月有13例患者（占87％）接受了移植（表1）。平均亨德森评分在3个月时为4.6，在6个月时为4.5，并且在3个月时9例患者完全治愈，在6个月时11例患者（73％）完全治愈。平均T＆A分数从141显着提高到184（P <.05）。 13例患者没有肘部疼痛，1例患者偶有轻度投掷性疼痛，所有这些患者（93％）在6个月时恢复了竞争水平。其余一名患者的重建率为24％，MRI显示6个月的愈合不完全，由于肘部疼痛和接受了翻修手术而难以投掷。完全愈合与移植物或病变大小之间没有关系（平均移植物大小：完整7.4 mm，不完整6.8 mm，P = 0.16，平均病变大小：完整166 mm2，不完整220 mm2，P = 0.13）。另一方面，重建率达到36％或以上的9例患者全部治愈，而6例少于36％的患者中有2例（33％）完全治愈（P <.05）。结论：这些结果表明，我们的康复方案适用于自体骨软骨栓塞植入小脑强迫症后的年轻棒球运动员。尽管临床上并不需要重建整个关节缺损，但应重建超过36％的区域。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号