Kombine Acellular Kollajen Matrisi ve Yüksek Tibial Osteotomi Tedavisi Osteokondral Kusurlarda Etkili Midir? Ön çalışma

Yıl 2017, Cilt: 1 Sayı: 1, 2 - 6, 23.04.2017

Mehmet Nuri Konya , Erdal Horata , Gökhan Maralcan , Abdullah Recep Erten , Ozan Turamanlar

https://doi.org/10.30565/medalanya.270371

Cited By: 1

Öz

Amaç: Bu çalışmada,
aselüler kollajen matriks (AKM) ve Yüksek Tibial osteotomi-hücresel kollajen
matriks (AKM-YTO) kombinasyonu ile tedavi edilen 12 hastanın klinik ve
radyolojik sonuçlarını karşılaştırmak istedik.

 Yöntem: Bu çalışmada,
2014-2016 yılları arasında etik onayları alındıktan sonra kondral lezyonu olan
12 hasta prospektif olarak değerlendirildi. Manyetik rezonans görüntüleme(MRG)
ile kıkırdak hasarı tespit edildi ve kıkırdak dejenerasyonun hacmi Mimics
medikal görüntü işleme yazılım sistemi ile hesaplandı ve eksen sapması ise
X-ray ile teşhis edildi. Hastalar sadece AKM(Grup 1) ve kombine AKM-YTO(Grup 2)
olmak üzere iki gruba ayrıldı.

 Bulgular: Sadece AKM grubu 5
hastadan oluşmaktadır. Bu grupta ameliyat öncesi ortalama kıkırdak lezyon hacmi
77.11 ± 137.5 (0.27- 321.61) idi. Operasyon sonrası ortalama diz(HSS) skoru
175.20 ± 24.4 (150-203) ve kıkırdak lezyon hacmi 0.3 ± 0.03 (0-0.8) idi.
AKM-YTO grubu 7 hastadan oluşmaktadır. Bu grupta ise ameliyat öncesi ortalama
kıkırdak lezyon hacmi 112.72 ± 239 (0.27-653) idi. Ameliyat sonrası ortalama
diz(HSS) skoru 155 ± 20.4 (135-183) ve kıkırdak lezyon hacmi 0.26 ± 0.09
(0-0.69) idi.

 Sonuç: Bu sonuçlara göre,
tüm hastaların HSS skorları ve kıkırdak hacmi artmıştır ancak iki grup arasında
anlamlı bir farklılık bulunmamaktadır.

Anahtar Kelimeler

Kıkırdak, Yüksek Tibial Osteotomi, Asellüler Kollajen Matris

İs Combined Acellular Collagen Matrix and High Tibial Osteotomy Treatment Effective In Osteochondral Defects? Preliminary Study

Öz

Aim:  In this study, we want to compare clinical and
radiological results of 12 patient treated with acellular collagen matrix (ACM)
and High Tibial osteotomy-cellular collagen matrix(ACM-HTO) combination.

Method: In this study, we
evaluated 12 patients with chondral lesion prospectively the years of between
2014- 2016 after ethical approval. Cartilage damage was diagnosed with MRI and
cartilage degeneration volume was calculated with Mimics medical image
processing software and axis deviation was diagnosed with ortho X-ray. Patients
were divided into two groups. ACM only (Group 1) and ACM- HTO (Group 2).

 

Results:
 ACM only group consists of 5 patients.
Preoperative mean of chondral lesion volume was 77.11±137.5 (0.27-321.61).
Post-operative mean Knee  score was
175.20±24.4(150-203) and chondral lesion volume was 0.3±0.03(0-0.8). ACM-HTO
group consists of 7 patients. Preoperative mean of chondral lesion volume was
112.72±239(0.27- 653). Post-operative mean of HSS score was 155±20.4(135-183)
and chondral lesion volume was 0.26±0.09(0-0.69).

Conclusion: According to these
results, all patients’ HSS scores and Cartilage volume are increased, but there
were no significant differences were found between two groups.

Anahtar Kelimeler

Keywords: cartilage, high tibial osteotomy, acellular collagen matrix

Kaynakça

• 1. Atay T, Aslan A, Baydar ML, Ceylan B, Baykal B, Kirdemir V, et al. The efficacy of low- and high-molecular-weight hyaluronic acid applications after arthroscopic debridement in patients with osteoarthritis of the knee. Acta Orthop Traumatol Turc. 2008;42(4):228–33.
• 2. Aslan A, Kırdemir V, Atay T, Baykal YB, Aytekin Ö and Aydoğan FC. [The Efficacy of Intra-Articular Injection of Hyaluronic Acid With Supplemental Peroral Vitamin E Following Arthroscopic Debridement in the Treatment of Knee Osteoarthritis: A Prospective, Randomized, Controlled Study]. Türk Fiz Tıp Rehab Derg. 2012;58(3):199–203.
• 3. Christensen BB, Foldager CB, Olesen ML, Vingtoft L, Hendrik J, Rölfing D, et al. Experimental articular cartilage repair in the Göttingen minipig : the influence of multiple defects per knee. J Exp Orthop. Journal of Experimental Orthopaedics; 2015;2(13).
• 4. Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy. 1997;13(4):456–60.
• 5. Farmer JM, Martin DF, Boles CA, Curl WW. Chondral and osteochondral injuries. Diagnosis and management. Clin Sports Med. 2001;20(2):299–320.
• 6. O’Driscoll SW. Articular cartilage regeneration using periosteum. Clin Orthop Relat Res.1999;(367 Suppl):S186-203.
• 7. Knutsen G, Drogset JO, Engebretsen L, Grontvedt T et al. A Randomized Multicenter Trial Comparing Autologous Chondrocyte Implantation with Microfracture: Long-Term Follow-up at 14 to 15 Years. J Bone Joint Surg Am. 2016;98(16):1332–9.
• 8. Frohbergh ME, Guevara JM, Grelsamer RP, Barbe MF, He X, Simonaro CM, et al. Acid ceramidase treatment enhances the outcome of autologous chondrocyte implantation in a rat osteochondral defect model. Osteoarthr Cartil. 2016;24(4):752–62.
• 9. Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;(248):13–4.
• 10. Cirpar M, Korkusuz F. [The future of treatment for chondral and osteochondral lesions]. Acta Orthop Traumatol Turc. 2007;41(Suppl 2):153–9.
• 11. Clav A. Third-Generation Autologous Chondrocyte Implantation Versus Mosaicplasty for Knee Cartilage Injury : 2-Year Randomized Trial. J Orthop Res. 2016;34(4):658–65.
• 12. Sofu H, Kockara N, Oner A, Camurcu Y et al. Results of Hyaluronic Acid Based Cell-Free Scaffold Application in Combination With Microfracture for the Treatment of Osteochondral Lesions of the Knee: 2-Year Comparative Study. Arthroscopy 2017;33(1):209-16.
• 13. Henschel J, Eberle S, Augat P. Load distribution between cephalic screws in a dual lag screw trochanteric nail. J Orthop Surg Res. 2016; 11: 41.
• 14. Kahlenberg CA, Nwachukwu BU, Hamid KS, Steinhaus ME, Williams RJ 3rd. Analysis of Outcomes for High Tibial Osteotomies Performed With Cartilage Restoration Techniques. Arthroscopy. 2017;33(2):486-492.
• 15. Kumagai K, Akamatsu Y, Kobayashi H, Kusayama Y, Koshino T, Saito T. Factors affecting cartilage repair after medial opening-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2017;25(3):779-84.
• 16. Tsukada S, Wakui M. Is overcorrection preferable for repair of degenerated articular cartilage after open-wedge high tibial osteotomy? Knee Surg Sports Traumatol Arthrosc. 2017;25(3):785-792.