Hounsfield Unit values on the subchondral bone are related to clinical outcomes in bone marrow stimulation for osteochondral lesions of the talus

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science Pub Date : 2024-07-01 DOI:10.1016/j.jos.2023.06.002

Shingo Kawabata, Tomoyuki Nakasa, Yasunari Ikuta, Junichi Sumii, Akinori Nekomoto, Nobuo Adachi

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引用次数: 0

Abstract

Background

Poor clinical outcomes in bone marrow stimulation (BMS) for the osteochondral lesion of the talus (OLT) are caused by subchondral bone deterioration. It is reported that microfracture induces endochondral ossification in the subchondral bone, which may affect the subchondral bone condition after BMS. This study analyzed osteosclerotic patterns of the bed in OLTs on computed tomography (CT) images and the relationship between the subchondral bone condition and clinical outcomes of BMS.

Methods

Sixty-nine ankles in 61 patients with OLT were included. Hounsfield unit (HU) on the bed of OLTs was measured on CT images and the pattern of osteosclerosis or absorption in the bed was analyzed. In these patients, 25 ankles in 24 patients underwent BMS. They were divided into 2 groups according to the presence of bone marrow edema (BME) one year after surgery, and clinical outcomes were compared.

Results

HUs in the anterior region were significantly higher than those of other areas. In patients with BMS, the JSSF scale for BME positive group (88.0 ± 7.7 points) was significantly lower than that for BME negative group (95.0 ± 6.1 points) (p < 0.05) at the final follow-up. On preoperative CT images, HU values of the central region in the BME-positive group were significantly lower than those in the BME-negative group (p < 0.05).

Conclusion

Osteosclerotic changes in the anterior part of the bed were frequently observed, and BMS for the area with low HU values decreased clinical outcomes. BMS should be performed with attention to subchondral bone condition to obtain good clinical outcomes.

Level of evidence

4, case series.

查看原文本刊更多论文

软骨下骨的 Hounsfield 单位值与骨髓刺激治疗距骨软骨损伤的临床效果有关。

背景：骨髓刺激术（BMS）治疗距骨骨软骨损伤（OLT）的临床疗效不佳是由软骨下骨退化引起的。据报道，微骨折会诱导软骨下骨的内软骨骨化，这可能会影响 BMS 后软骨下骨的状况。本研究分析了计算机断层扫描（CT）图像上 OLT 骨床的骨硬化形态以及软骨下骨状况与 BMS 临床疗效之间的关系：方法：纳入 61 名 OLT 患者的 69 只脚踝。在 CT 图像上测量 OLT 骨床的 Hounsfield 单位（HU），并分析骨床的骨硬化或吸收模式。在这些患者中，24 名患者的 25 只脚踝接受了 BMS 治疗。根据术后一年是否出现骨髓水肿（BME）将他们分为两组，并比较临床结果：结果：前区的 HU 值明显高于其他区域。在 BMS 患者中，BME 阳性组的 JSSF 量表（88.0 ± 7.7 分）明显低于 BME 阴性组（95.0 ± 6.1 分）（P骨床前部经常出现骨硬化改变，对 HU 值较低的区域进行 BMS 会降低临床疗效。进行 BMS 时应注意软骨下骨的状况，以获得良好的临床效果：4，病例系列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Orthopaedic Science 医学-整形外科

CiteScore

3.00

自引率

0.00%

发文量

290

审稿时长

90 days

期刊介绍： The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.