自体骨软骨移植治疗膝关节软骨下不全骨折后自发性骨坏死的10年预后良好。

IF 4.4 Q2 Medicine
Kohei Nishitani, Yasuaki Nakagawa, Masahiko Kobayashi, Shinichiro Nakamura, Shogo Mukai, Shinichi Kuriyama, Shuichi Matsuda
{"title":"自体骨软骨移植治疗膝关节软骨下不全骨折后自发性骨坏死的10年预后良好。","authors":"Kohei Nishitani, Yasuaki Nakagawa, Masahiko Kobayashi, Shinichiro Nakamura, Shogo Mukai, Shinichi Kuriyama, Shuichi Matsuda","doi":"10.1186/s43019-025-00285-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The long-term effect of osteochondral autologous transplantation (OAT) on spontaneous osteonecrosis of the knee (SONK) following subchondral insufficiency fracture remains unclear. This study aimed to evaluate the long-term survivorship and clinical outcomes of OAT for SONK, with a focus on factors associated with clinical success.</p><p><strong>Methods: </strong>Patients who underwent OAT for SONK between 1998 and 2009 were retrospectively reviewed. Survivorship was assessed using Kaplan-Meier analysis, with revision surgery as the endpoint. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) subjective score obtained preoperatively and at final follow-up. Clinical failure was defined as an IKDC score below the patient acceptable symptom state (PASS; 62.1 points). The association between final IKDC score and postoperative femorotibial angle (FTA) was analyzed using linear and quadratic regression.</p><p><strong>Results: </strong>A total of 33 OATs were included (mean age: 64.6 ± 8.0 years; mean lesion size: 3.9 ± 1.7 cm<sup>2</sup>). High tibial osteotomy was performed in 15 patients with FTA > 180°, and 24 patients were followed for ≥ 10 years (mean: 13.7 ± 3.4 years). One arthroplasty was performed at 14.2 years, yielding a 15-year survival rate of 88%. The IKDC score improved significantly (35.0 ± 12.6 to 70.6 ± 14.1, p < 0.001), with a clinical success rate of 79.2%. Quadratic regression showed optimal postoperative FTA between 163.1° and 178.3° for achieving PASS.</p><p><strong>Conclusions: </strong>OAT may provide favorable long-term survivorship and clinical outcomes in SONK, particularly when postoperative alignment is appropriately corrected.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"34"},"PeriodicalIF":4.4000,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341072/pdf/","citationCount":"0","resultStr":"{\"title\":\"Favorable 10-year outcomes of osteochondral autologous transplantation for spontaneous osteonecrosis of the knee following subchondral insufficiency fracture with optimal alignment correction.\",\"authors\":\"Kohei Nishitani, Yasuaki Nakagawa, Masahiko Kobayashi, Shinichiro Nakamura, Shogo Mukai, Shinichi Kuriyama, Shuichi Matsuda\",\"doi\":\"10.1186/s43019-025-00285-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The long-term effect of osteochondral autologous transplantation (OAT) on spontaneous osteonecrosis of the knee (SONK) following subchondral insufficiency fracture remains unclear. This study aimed to evaluate the long-term survivorship and clinical outcomes of OAT for SONK, with a focus on factors associated with clinical success.</p><p><strong>Methods: </strong>Patients who underwent OAT for SONK between 1998 and 2009 were retrospectively reviewed. Survivorship was assessed using Kaplan-Meier analysis, with revision surgery as the endpoint. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) subjective score obtained preoperatively and at final follow-up. Clinical failure was defined as an IKDC score below the patient acceptable symptom state (PASS; 62.1 points). The association between final IKDC score and postoperative femorotibial angle (FTA) was analyzed using linear and quadratic regression.</p><p><strong>Results: </strong>A total of 33 OATs were included (mean age: 64.6 ± 8.0 years; mean lesion size: 3.9 ± 1.7 cm<sup>2</sup>). High tibial osteotomy was performed in 15 patients with FTA > 180°, and 24 patients were followed for ≥ 10 years (mean: 13.7 ± 3.4 years). One arthroplasty was performed at 14.2 years, yielding a 15-year survival rate of 88%. The IKDC score improved significantly (35.0 ± 12.6 to 70.6 ± 14.1, p < 0.001), with a clinical success rate of 79.2%. Quadratic regression showed optimal postoperative FTA between 163.1° and 178.3° for achieving PASS.</p><p><strong>Conclusions: </strong>OAT may provide favorable long-term survivorship and clinical outcomes in SONK, particularly when postoperative alignment is appropriately corrected.</p>\",\"PeriodicalId\":36317,\"journal\":{\"name\":\"Knee Surgery and Related Research\",\"volume\":\"37 1\",\"pages\":\"34\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2025-08-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341072/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery and Related Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s43019-025-00285-2\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery and Related Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s43019-025-00285-2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

摘要

目的:骨软骨自体移植(OAT)对软骨下不全骨折后自发性膝骨坏死(SONK)的长期影响尚不清楚。本研究旨在评估OAT治疗SONK的长期生存期和临床结果,重点关注与临床成功相关的因素。方法:回顾性分析1998 ~ 2009年间因SONK接受OAT治疗的患者。生存率采用Kaplan-Meier分析,以翻修手术为终点。临床结果采用国际膝关节文献委员会(IKDC)术前和最终随访时的主观评分进行评估。临床失败定义为IKDC评分低于患者可接受症状状态(PASS;62.1分)。采用线性和二次回归分析最终IKDC评分与术后股胫角(FTA)的关系。结果:共纳入33例oat患者(平均年龄64.6±8.0岁;平均病灶大小:3.9±1.7 cm2)。15例ftb0 180°患者行胫骨高位截骨术,24例随访≥10年(平均:13.7±3.4年)。14.2年时进行了一次关节置换术,15年生存率为88%。IKDC评分显著提高(35.0±12.6至70.6±14.1,p)。结论:OAT可能提供良好的SONK长期生存期和临床结果,特别是在术后对齐得到适当纠正时。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Favorable 10-year outcomes of osteochondral autologous transplantation for spontaneous osteonecrosis of the knee following subchondral insufficiency fracture with optimal alignment correction.

Purpose: The long-term effect of osteochondral autologous transplantation (OAT) on spontaneous osteonecrosis of the knee (SONK) following subchondral insufficiency fracture remains unclear. This study aimed to evaluate the long-term survivorship and clinical outcomes of OAT for SONK, with a focus on factors associated with clinical success.

Methods: Patients who underwent OAT for SONK between 1998 and 2009 were retrospectively reviewed. Survivorship was assessed using Kaplan-Meier analysis, with revision surgery as the endpoint. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) subjective score obtained preoperatively and at final follow-up. Clinical failure was defined as an IKDC score below the patient acceptable symptom state (PASS; 62.1 points). The association between final IKDC score and postoperative femorotibial angle (FTA) was analyzed using linear and quadratic regression.

Results: A total of 33 OATs were included (mean age: 64.6 ± 8.0 years; mean lesion size: 3.9 ± 1.7 cm2). High tibial osteotomy was performed in 15 patients with FTA > 180°, and 24 patients were followed for ≥ 10 years (mean: 13.7 ± 3.4 years). One arthroplasty was performed at 14.2 years, yielding a 15-year survival rate of 88%. The IKDC score improved significantly (35.0 ± 12.6 to 70.6 ± 14.1, p < 0.001), with a clinical success rate of 79.2%. Quadratic regression showed optimal postoperative FTA between 163.1° and 178.3° for achieving PASS.

Conclusions: OAT may provide favorable long-term survivorship and clinical outcomes in SONK, particularly when postoperative alignment is appropriately corrected.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
6.50
自引率
0.00%
发文量
42
审稿时长
19 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信