股骨头骨软骨同种异体移植或自体移植可改善疗效，但存活率不一：系统回顾。

IF 4.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2025-02-01 DOI:10.1016/j.arthro.2024.02.008

Scott Fong B.A. , Michael S. Lee B.A. , Nicholas Pettinelli B.S. , Mackenzie Norman M.D. , Nancy Park B.S. , Stephen M. Gillinov A.B. , Justin Zhu B.A. , Jack Gagné M.D. , Amy Y. Lee B.A. , Ronak J. Mahatme B.S. , Andrew E. Jimenez M.D.

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引用次数: 0

摘要

目的：回顾接受股骨头骨软骨自体或异体移植（OAT）患者的患者报告结果（PROs）和存活率：于2022年11月在Pubmed、Cochrane对照试验注册中心（CENTRAL）和Scopus数据库中进行了检索，更新后的检索时间延长至2023年12月，检索时使用了系统综述和Meta分析首选报告项目（PRISMA）中的标准和以下关键词：（髋关节或股骨头）和（镶嵌成形术或骨软骨异体移植术或骨软骨自体移植术或骨软骨病变）。如果文章对接受股骨头OAT手术的患者进行了术后PROs评估，且研究规模为5个或5个以上髋关节（n≥5），则纳入该文章。存活率被定义为不转为 THA。对于三项或更多研究中评估的PROs，绘制森林图并计算I2：本综述共纳入了 12 项研究，共计 156 个髋关节，平均随访时间从 16.8 个月到 222 个月不等。104例（66.7%）患者为男性，52例（33.3%）为女性。患者年龄在 17.0 至 35.4 岁之间，体重指数在 23.3 至 28.1 之间。八项研究报告了骨软骨自体移植，四项研究报告了骨软骨异体移植。三项研究报告了至少一项PRO指标的明显改善。在至少两年的随访中，存活率从61.5%到96%不等，在至少五年的随访中，存活率从57.1%到91%不等。在少于五年的随访中，骨软骨异体移植的存活率为70%至87.5%，而自体移植的存活率为61.54%至96%：研究设计：研究设计：IV级研究的系统性回顾，证据等级IV。

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Osteochondral Allograft or Autograft Transplantation of the Femoral Head Leads to Improvement in Outcomes but Variable Survivorship: A Systematic Review

Purpose

To review patient-reported outcomes (PROs) and survivorship in patients undergoing osteochondral autograft or allograft transplantation (OAT) of the femoral head.

Methods

PubMed, Cochrane Center for Register of Controlled Trials, and Scopus databases were searched in November 2022 with an updated search extending to December 2023 using criteria from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the following keywords: (hip OR femoral head) AND (mosaicplasty OR osteochondral allograft OR osteochondral autograft OR osteochondral lesion). Articles were included if they evaluated postoperative PROs in patients who underwent OAT of the femoral head and had a study size of 5 or more hips (n ≥ 5). Survivorship was defined as freedom from conversion to total hip arthroplasty. For PROs evaluated in 3 studies or more, forest plots were created and I² was calculated.

Results

Twelve studies were included in this review, with a total of 156 hips and a mean follow-up time ranging between 16.8 and 222 months. In total, 104 (66.7%) hips were male while 52 (33.3%) were female. Age of patients ranged from 17.0 to 35.4 years, while body mass index ranged from 23.3 to 28.1. Eight studies reported on osteochondral autograft transplantation and 4 studies on osteochondral allograft transplantation. Three studies reported significant improvement in at least 1 PRO. Survivorship ranged from 61.5% to 96% at minimum 2-year follow-up and from 57.1% to 91% at minimum 5-year follow-up. At a follow-up of less than 5 years, osteochondral allograft transplantation studies showed 70% to 87.5% survivorship, while autograft varied from 61.54% to 96%.

Conclusions

Patients with osteochondral lesions of the femoral head who underwent osteochondral autograft or allograft transplantation demonstrated improved PROs but variable survivorship rates.

Level of Evidence

Level IV, systematic review of Level IV studies.

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来源期刊

Arthroscopy-The Journal of Arthroscopic and Related Surgery 医学-外科

CiteScore

9.30

自引率

17.00%

发文量

555

审稿时长

58 days

期刊介绍： Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.