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DOI: 10.1055/s-0030-1250591
© Georg Thieme Verlag KG Stuttgart · New York
Mittelfristige klinische und kernspintomografische Ergebnisse nach Refixation osteochondraler Fragmente mit resorbierbaren Implantaten
Mid-Term Clinical and MRI Results after Refixation of Osteochondral Fractures with Resorbable ImplantsPublication History
Publication Date:
21 January 2011 (online)
![](https://www.thieme-connect.de/media/zfo/201101/lookinside/thumbnails/10.1055-s-0030-1250591-1.jpg)
Zusammenfassung
Studienziel: Die Refixation von osteochondralen Fragmenten mit resorbierbaren Implantaten ist ein häufig durchgeführter Eingriff. Es existieren jedoch kaum Studien, die den klinischen Erfolg dieser Methode belegen. Ziel der Studie war es deshalb, mittelfristige Ergebnisse nach osteochondraler Refixation zu evaluieren. Methode: Erfasst wurden 12 Patienten durchschnittlich 6,5 (±1) Jahre nach Refixation eines durchschnittlich 3,4 cm2 (±2,5) großen osteochondralen Flakes am Knie- (8 ×) bzw. oberen Sprunggelenk (4 ×) mit resorbierbaren Implantaten. Zur Anwendung kamen klinische Scores sowie ein modifizierter MRT-Score nach Henderson et al. Ergebnisse: Die Ergebnisse der klinischen Scores zeigten nach 6,5 (±1) Jahren gute bis sehr gute Ergebnisse (VAS Schmerz: 1,9 [±2,4], Tegner: 5,0 [±1,7], Lysholm: 84,8 [±14,3], McDermott: 91,3 [±7,9], Knee-Society: 189,4 [±12,1]). In der MRT konnte bis auf 1 Fall eine gute Integration des refixierten Flakes nachgewiesen werden. In 3 Fällen kam es zu einer subchondralen Zystenbildung. In 7 Fällen zeigte sich eine Veränderung in der Knorpelkontur. Hieraus ergab sich ein durchschnittlicher Henderson-Score-Wert von 12,6 (±3,7). Die MRT-Ergebnisse korrelierten nicht mit dem klinischen Outcome. Schlussfolgerungen: Aufgrund der guten klinischen Ergebnisse ist die Refixation osteochondraler Fragmente mit resorbierbaren Implantaten ein empfehlenswertes Vorgehen.
Abstract
Aim: Refixation of osteochondral fractures with resorbable implants is a common surgical treatment. There are almost no studies that prove good clinical outcomes. Hence, the aim of the study was to evaluate the mid-term results after refixation of osteochondral fractures. Methods: The results of 12 patients were recorded 6.5 (±1) years after refixation of osteochondral fractures measuring 3.4 cm2 (±2.5) of the knee (8 ×) or the ankle joint (4 ×) with resorbable inplants. Clinical scores and a modified MRI score based on that of Henderson et al. were used. Results: The clinical scores showed good to excellent results after 6.5 (±1) years (VAS pain: 1.9 [±2.4], Tegner: 5.0 [±1.7], Lysholm: 84.8 [±14.3], McDermott: 91.3 [±7.9], Knee Society: 189.4 [±12.1]). MRI showed with one exception good integration of the fractures. In 3 cases subchondral cysts could be found. In 7 cases changes in the chondral outline occurred. The effect of this was a modified Henderson score of 12.6 (±3.7). The MRI results did not correlate with the clinical outcome. Conclusion: Because of its good clinical results the refixation with resorbable implants can be recommended to treat osteochondral fractures.
Schlüsselwörter
Refixation - MRT - resorbierbare Implantate - osteochondrale Fragmente
Key words
refixation - MRI - resorbable implants - osteochondral fractures
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Dr. Martin Michael Wachowski
Abteilung für Unfallchirurgie, Plastische und Wiederherstellungschirurgie
Universitätsmedizin Göttingen
Robert-Koch-Straße 40
37075 Göttingen
Phone: 05 51/39 61 14
Fax: 05 51/39 89 81
Email: martin.wachowski@web.de