前踝截骨联合自体骨软骨移植治疗距骨软骨损伤的效果观察

目的:探讨前踝截骨联合自体骨软骨移植治疗距骨软骨损伤的临床效果。方法:回顾性研究。纳入2014年1月—2017年1月徐州市中心医院骨科16例（16足）距骨软骨损伤患者的临床资料。其中，男6例、女10例，年龄18～67（33.4±11.1）岁；右侧7例，左侧9例。患者均采用前踝截骨联合自体骨软骨移植治疗距骨软骨损伤。比较...

The clinical effect of autologous osteochondral transplantation via anterior ankle osteotomy for osteochondral lesions of the talus combined with subchondral cysts

Objective To investigate the clinical effect of anterior ankle osteotomy combined with autologous osteochondral transplantation in the treatment of talar cartilage injury. Methods The clinical data of 16 patients (16 feet) with talus cartilage injury in the Department of Orthopaedics of Xuzhou Central Hospital from January 2014 to January 2017 were included. Among them, 6 were males and 10 were females. The patients were aged 18-67 (33.4±11.1) years. Seven cases of talus cartilage injury were located on the right, and nine on the left. Anterior ankle osteotomy combined with autologous osteochondral transplantation was used to treat talar cartilage injury. Regular follow-up was performed after operation. The visual analogue scale (VAS) score and American Orthopaedic Foot and Ankle Society (AOFAS) score were compared before operation and at the last follow-up. The therapeutic effect of the operation was evaluated by using the magnetic resonance observation of cartilage repair tissue (MOCART) score at 2 years after surgery. Results All incisions healed in one stage. Sixteen patients were followed up for 36-72 (46.6±12.8) months. At the last follow-up, the VAS score improved from (6.9±1.6) to (0.8±0.8), and the AOFAS score increased from (60.7±10.8) to (90.9±5.6), which was statistically significant compared with that before operation (t=18.67, 13.92; all P values <0.001). At the last follow-up, ankle function was excellent in 14 cases and good in two cases, with an excellent and good rate of 16/16. Two years after surgery, MRI showed that the osteotomy surfaces healed well, and the defect areas of the original lesions were filled with grafts. The average MOCART score was (65.0±10.2). Conclusion Anterior ankle osteotomy combined with autologous osteochondral transplantation in the treatment of talar cartilage injury has good ankle function recovery, obvious symptom relief, and good clinical effect.