| 踝关节镜下微骨折术治疗距骨骨软骨损伤的疗效研究 |
| Study on the efficacy of ankle arthroscopic microfracture in the treatment of osteochondral lesions of the talus |
| 投稿时间：2024-04-03 |
| DOI：10.3969/j.issn.1672-5972.2025.03.010 |
| 中文关键词: 踝关节镜 微骨折术 骨软骨损伤 |
| 英文关键词:Ankle arthroscopy Microfracture Cartilage damage |
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| 中文摘要: |
| 目的 探讨踝关节镜下微骨折术治疗距骨骨软骨损伤的疗效。方法 回顾性分析自2019年2月至2022年2月南京医科大学附属南京医院运动关节科收治的65例踝关节镜下微骨折术治疗距骨骨软骨损伤的患者。比较术前、术后的疼痛视觉模拟评分（visual analogue scale, VAS）、美国足踝外科踝-后足评分（American Orthopedic Foot and Ankle Surgery, AOFAS）、Karlsson-Peterson（K-P）踝关节功能评分、MRI脂肪抑制序列矢状位下距骨骨髓水肿的最大面积。结果 65例患者均顺利完成手术，且均未出现严重并发症。平均随访（18.9±3.9）个月中，患者正常的日常生活与体育活动功能均获得良好恢复。末次随访VAS评分为（2.26±1.25）分，显著低于术前（6.60±1.47）分，差异有统计学意义（P＜0.05）；末次随访AOFAS评分为（86.68±7.84）分，显著高于术前（55.74±8.16）分，差异有统计学意义（P＜0.05）；末次随访Karlsson-Peterson（K-P）踝关节功能评分为（91.34±7.38）分，显著高于术前（50.20±6.08）分，差异有统计学意义（P＜0.05）；术后MRI骨髓水肿面积为（41.80±17.91）mm2，相比术前（89.02±29.92）mm2显著减小，差异有统计学意义（P＜0.05）。结论 踝关节镜下微骨折术能有效减轻患者疼痛，明显改善患者的踝关节功能，可以促进患者踝关节软骨修复过程，是治疗距骨骨软骨损伤的可靠手术方式。 |
| 英文摘要: |
| Objective To discuss the efficacy of ankle arthroscopic microfracture in the treatment of osteochondral lesions of the talus.Methods A retrospective analysis was performed on 65 patients with osteochondral lesions of the talus treated with ankle arthroscopic microfracture at Nanjing Hospital Affiliated to Nanjing Medical University from February 2019 to February 2022. The visual analogue scale (VAS), American Orthopedic Foot and Ankle Surgery score(AOFAS), Karlsson-Peterson (K-P) ankle function score and the maximum area of sagittal talus bone marrow edema in MRI fat suppression sequence were compared before and after operation.Results Surgery was successfully completed in all 65 cases with no serious complications. The patients' function of daily living and physical activity recovered well in (18.9±3.9) months. The VAS score at the last follow-up after the operation [(2.26±1.25) scores] was significantly lower than the score before the operation [(6.60±1.47) scores], and the difference was statistically significant (P<0.05). The AOFAS score at the last follow-up after the operation [(86.68±7.84) scores] was significantly higher than the score before the operation [(55.74±8.16) scores], and the difference was statistically significant (P<0.05). The postoperative Karlsson-Peterson (K-P) ankle function score [(91.34±7.38) scores] was significantly higher than the preoperative score [(50.20±6.08) scores], and the difference was statistically significant (P<0.05). The postoperative MRI bone marrow edema area [(41.80±17.91) mm2] was significantly reduced compared with the preoperative [(89.02±29.92) mm2], and the difference was statistically significant (P<0.05).Conclusion Ankle arthroscopic microfracture can effectively reduce the patients' pain, significantly improve patients' ankle joint function, and promote patients' ankle cartilage repair process. It is a reliable surgical treatment for osteochondral lesions of the talus. |
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