Simultaneous arthroscopic implantation of autologous chondrocytes and high tibial osteotomy for tibial chondral defects in the varus knee

被引:58
作者
Franceschi, Francesco [2 ]
Longo, Umile Giuseppe [2 ]
Ruzzini, Laura [2 ]
Marinozzi, Andrea [2 ]
Maffulli, Nicola [1 ]
Denaro, Vincenzo [2 ]
机构
[1] Keele Univ, Dept Trauma & Orthopaed Surg, Univ Hosp N Staffordshire, Sch Med, Stoke On Trent ST4 7LN, Staffs, England
[2] Campus Biomed Univ, Dept Orthopaed & Trauma Surg, I-00128 Rome, Italy
关键词
high tibial osteotomy; arthroscopic autologous chondrocyte implantation; varus knee; chondral defects; knee; arthroscopy;
D O I
10.1016/j.knee.2008.04.007
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
There is no consensus on the ideal management of patients with chondral defects of the medial tibial plateau and varus malalignment of the knee. We performed a cohort study to evaluate the outcome of patients affected by these conditions, who underwent arthroscopic implantation of autologous chondrocytes and a medial opening wedge high tibial osteotomy. Eight patients (four men and four women; mean age, 50 years, range: 42 to 58) with chondral defects of the medial tibial plateau in a varus knee underwent arthroscopic implantations of autologous chondrocytes in conjunction with a medial opening wedge osteotomy. At final post-operative follow up of 28 months following the index procedure, the postoperative scores were improved for the IKDC score (four patients abnormal and four patients severely abnonnal to four patients normal, three patients nearly normal and one patient abnon-nal), Lysholm score (65.7 range 49-88 to 94.6 range89-100), Tegner score (3.7 range3-5 to 7 range 5-8) and VAS score (7.2 to 2.0). In conclusion, the association of arthroscopic implantation of autologous chondrocytes with a medial opening wedge osteotomy of the proximal tibia is a viable option for the management of chondral defects in varus knees. Crown Copyright (c) 2008 Published by Elsevier B.V All rights reserved.
引用
收藏
页码:309 / 313
页数:5
相关论文
共 34 条
[1]
Does arthroscopic abrasion arthroplasty promote cartilage regeneration in osteoarthritic knees with eburnation? A prospective study of high tibial osteotomy with abrasion arthroplasty versus high tibial osteotomy alone [J].
Akizuki, S ;
Yasukawa, Y ;
Takizawa, T .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 1997, 13 (01) :9-17
[2]
Cartilage restoration, part 2 - Techniques, outcomes, and future directions [J].
Alford, JW ;
Cole, BJ .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2005, 33 (03) :443-460
[3]
Cartilage restoration, part 1 - Basic science, historical perspective, patient evaluation, and treatment options [J].
Alford, JW ;
Cole, BJ .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2005, 33 (02) :295-306
[4]
High tibial osteotomy for the treatment of unicompartmental arthritis of the knee [J].
Amendola, A ;
Panarella, L .
ORTHOPEDIC CLINICS OF NORTH AMERICA, 2005, 36 (04) :497-+
[5]
Anderson AF., KNEE SURG, V1994, P275
[6]
Total knee arthroplasty after failed proximal tibial valgus osteotomy [J].
Bergenudd, H ;
Sahlstrom, A ;
Sanzen, L .
JOURNAL OF ARTHROPLASTY, 1997, 12 (06) :635-638
[7]
Histological and biochemical evaluation of perichondrial transplants in human articular cartilage defects [J].
Bouwmeester, P ;
Kuijer, R ;
Terwindt-Rouwenhorst, E ;
van der Linden, T ;
Bulstra, K .
JOURNAL OF ORTHOPAEDIC RESEARCH, 1999, 17 (06) :843-849
[8]
TREATMENT OF DEEP CARTILAGE DEFECTS IN THE KNEE WITH AUTOLOGOUS CHONDROCYTE TRANSPLANTATION [J].
BRITTBERG, M ;
LINDAHL, A ;
NILSSON, A ;
OHLSSON, C ;
ISAKSSON, O ;
PETERSON, L .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (14) :889-895
[9]
Osteotomy for medial compartment arthritis of the knee using a closing wedge or an opening wedge controlled by a Puddu plate - A one-year randomised, controlled study [J].
Brouwer, R. W. ;
Bierma-Zeinstra, S. M. A. ;
van Raaij, T. M. ;
Verhaar, J. A. N. .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2006, 88B (11) :1454-1459
[10]
DUGDALE TW, 1992, CLIN ORTHOP RELAT R, P248