Yıl: 2019 Cilt: 30 Sayı: 2 Sayfa Aralığı: 97 - 105 Metin Dili: İngilizce DOI: 10.5606/ehc.2019.64401 İndeks Tarihi: 25-11-2019

Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions

Öz:
Objectives: This study aims to compare two single-step arthroscopic techniques, microfracture and cell-free scaffold implantation, in the treatment of talar osteochondral lesions (OCLs) clinically and radiologically. Patients and methods: This retrospective study included 62 patients (35 males, 27 females; mean age 41±13 years; range, 15 to 65 years) diagnosed with talar OCLs between March 2007 and January 2015. Patients who were followed-up with a minimum of 24 months with lesions larger than 1 cm2 were included. Pre- and postoperative clinical evaluations were performed according to the American Orthopedic Foot and Ankle Society (AOFAS) anklehindfoot scale and radiological evaluations according to the magnetic resonance observation of cartilage repair tissue (MOCART) scale. Results: Patients were divided into microfracture (n=22) and scaffold (n=40) groups. The mean follow-up duration was 36.1±14.9 months. The mean preoperative AOFAS score increased from 60.6±13.9 to 82.1±11.8 in the microfracture group (p<0.001) and from 53.8±13.6 to 89.4±9.9 in the scaffold group (p<0.001). The scaffold group had superior results than the microfracture group clinically (p=0.011). Clinical results were superior in younger patients (<45 years) (p=0.018), male patients (p=0.020), and traumatic lesions (p=0.014). There was no significant difference between the two techniques according to the total MOCART scores (p=0.199). However, the scaffold technique was more successful in terms of lesion border and effusion subgoups of MOCART scale. Conclusion: Both single-step arthroscopic techniques are effective and safe in the treatment of talar OCLs. The scaffold technique showed superior clinical results than the microfracture technique in short-term follow-up. Age, trauma history and gender significantly affected the treatment outcomes. The scaffold technique can be considered as a safe and good alternative particularly in the treatment of large lesions.
Anahtar Kelime:

Konular: Romatoloji Cerrahi Ortopedi

Talar osteokondral lezyonların tedavisinde artroskopik mikrokırık ve hücresiz çatı implantasyonu tekniklerinin karşılaştırılması

Öz:
Amaç: Bu çalışmada talar osteokondral lezyon (OKL)’ların tedavisinde tek aşamalı iki artroskopik teknik olan mikrokırık ve hücresiz çatı implantasyonu klinik ve radyolojik olarak karşılaştırıldı. Hastalar ve yöntemler: Bu retrospektif çalışmaya Mart 2007 ve Ocak 2015 tarihleri arasında talar OKL tanısı konulmuş olan 62 hasta (35 erkek, 27 kadın; ort. yaş 41±13 yıl; dağılım, 15-65 yıl) dahil edildi. Minimum 24 ay takip edilen ve lezyonları 1 cm2’den büyük olan hastalar çalışmaya dahil edildi. Ameliyat öncesi ve sonrası klinik değerlendirmeler Amerikan Ortopedik Ayak ve Ayak Bileği Cemiyeti (AOFAS) ayak bileği-arka ayak ölçeği ve radyolojik değerlendirmeler kıkırdak tamir dokusunun manyetik rezonans gözlemi (MOCART) ölçeğine göre yapıldı. Bulgular: Hastalar mikrokırık (n=22) ve hücresiz çatı (n=40) gruplarına ayrıldı. Ortalama takip süresi 36.1±14.9 ay idi. Ameliyat öncesi ortalama AOFAS skoru mikrokırık grubunda 60.6±13.9’dan 82.1±11.8’e (p<0.001) ve hücresiz çatı grubunda 53.8±13.6’dan 89.4±9.9’a (p<0.001) yükseldi. Hücresiz çatı grubu sonuçlarının klinik olarak mikrokırık grubundan daha iyi olduğu görüldü (p=0.011). Klinik sonuçların daha genç (<45 yıl) (p=0.018), erkek (p=0.020) hastalarda ve travmatik lezyonlarda (p=0.014) daha iyi olduğu görüldü. Toplam MOCART skorlarına göre iki teknik arasında anlamlı farklılık yoktu (p=0.199). Fakat hücresiz çatı tekniği; MOCART skorlamasının lezyon kenarı ve efüzyon alt grupları açısından daha başarılı oldu. Sonuç: Her iki tek aşamalı artroskopik teknik de talar OKL’lerin tedavisinde etkili ve güvenlidir. Hücresiz çatı tekniği kısa dönem takipte mikrokırık tekniğinden daha iyi klinik sonuçlar göstermiştir. Yaş, travma öyküsü ve cinsiyet tedavi sonuçlarını anlamlı şekilde etkilemiştir. Hücresiz çatı tekniği özellikle büyük lezyonların tedavisinde güvenli ve iyi bir alternatif olarak kabul edilebilir.
Anahtar Kelime:

Konular: Romatoloji Cerrahi Ortopedi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA EREN T, Ataoğlu B, Eren A, GEYLAN D, ÖNER A, Kanatlı U (2019). Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions. , 97 - 105. 10.5606/ehc.2019.64401
Chicago EREN Toygun Kağan,Ataoğlu Baybars,Eren Ali,GEYLAN Dilan Ece,ÖNER Ali Yusuf,Kanatlı Ulunay Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions. (2019): 97 - 105. 10.5606/ehc.2019.64401
MLA EREN Toygun Kağan,Ataoğlu Baybars,Eren Ali,GEYLAN Dilan Ece,ÖNER Ali Yusuf,Kanatlı Ulunay Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions. , 2019, ss.97 - 105. 10.5606/ehc.2019.64401
AMA EREN T,Ataoğlu B,Eren A,GEYLAN D,ÖNER A,Kanatlı U Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions. . 2019; 97 - 105. 10.5606/ehc.2019.64401
Vancouver EREN T,Ataoğlu B,Eren A,GEYLAN D,ÖNER A,Kanatlı U Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions. . 2019; 97 - 105. 10.5606/ehc.2019.64401
IEEE EREN T,Ataoğlu B,Eren A,GEYLAN D,ÖNER A,Kanatlı U "Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions." , ss.97 - 105, 2019. 10.5606/ehc.2019.64401
ISNAD EREN, Toygun Kağan vd. "Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions". (2019), 97-105. https://doi.org/10.5606/ehc.2019.64401
APA EREN T, Ataoğlu B, Eren A, GEYLAN D, ÖNER A, Kanatlı U (2019). Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 30(2), 97 - 105. 10.5606/ehc.2019.64401
Chicago EREN Toygun Kağan,Ataoğlu Baybars,Eren Ali,GEYLAN Dilan Ece,ÖNER Ali Yusuf,Kanatlı Ulunay Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 30, no.2 (2019): 97 - 105. 10.5606/ehc.2019.64401
MLA EREN Toygun Kağan,Ataoğlu Baybars,Eren Ali,GEYLAN Dilan Ece,ÖNER Ali Yusuf,Kanatlı Ulunay Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), vol.30, no.2, 2019, ss.97 - 105. 10.5606/ehc.2019.64401
AMA EREN T,Ataoğlu B,Eren A,GEYLAN D,ÖNER A,Kanatlı U Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2019; 30(2): 97 - 105. 10.5606/ehc.2019.64401
Vancouver EREN T,Ataoğlu B,Eren A,GEYLAN D,ÖNER A,Kanatlı U Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2019; 30(2): 97 - 105. 10.5606/ehc.2019.64401
IEEE EREN T,Ataoğlu B,Eren A,GEYLAN D,ÖNER A,Kanatlı U "Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions." Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 30, ss.97 - 105, 2019. 10.5606/ehc.2019.64401
ISNAD EREN, Toygun Kağan vd. "Comparison of arthroscopic microfracture and cell-free scaffold implantation techniques in the treatment of talar osteochondral lesions". Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 30/2 (2019), 97-105. https://doi.org/10.5606/ehc.2019.64401