대한족부족관절학회지 (Journal of Korean Foot and Ankle Society)

  • 제21권4호
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  • Pages.139-143
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  • 2017
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  • 1738-3757(pISSN)
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  • 2288-8551(eISSN)
대한족부족관절학회 (Korean Foot & Ankle Society)
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거골의 골연골 병변에 대한 자가 골연골 이식술의 결과: 내과 절골 도달법과 전방 관절낭 절개 도달법의 비교

Results of Autologous Osteochondral Transplantation of the Ostochondral Lesion on the Talus: A Comparison Study between Medial Malleolar Osteotomy Approach and Anterior Arthrotomy Approach

  • 이용식 (포항성모병원 정형외과) ;
  • 안길영 (포항성모병원 정형외과) ;
  • 남일현 (포항성모병원 정형외과) ;
  • 이영현 (포항성모병원 정형외과) ;
  • 이태훈 (포항성모병원 정형외과) ;
  • 김대근 (포항성모병원 정형외과) ;
  • 이동현 (포항성모병원 정형외과)
  • Lee, Yong-Sik (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Ahn, Gil-Yeong (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Nam, Il-Hyun (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Lee, Yeong-Hyun (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Lee, Tae-Hun (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Kim, Dae-Geun (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Lee, Dong-Hyun (Department of Orthopedic Surgery, Pohang St. Mary's Hospital)
  • 투고 : 2017.10.23
  • 심사 : 2017.11.13
  • 발행 : 2017.12.15
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초록

Purpose: Osteochondral lesion of the talus (OLT) has traditionally been treated using an autologous osteochondral graft via the medial malleolar approach. Here, we compare the traditional method with the anterior arthrotomy approach. Materials and Methods: Between January 2005 and June 2015, 24 cases of patients who received autologus osteochondral graft for OLT and with at least 2 years of follow-up were evaluated. They were divided into two groups; one group receiving autologous osteochondral graft via the medial malleolar osteotomy approach (group 1, n=9) and another group via the anterior arthrotomy approach (group 2, n=15). The clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: In all cases, the size of the subchondral cyst of the talus decreased, if not disappeared on the final follow-up radiograph. All osteochondral grafts were united. The mean AOFAS score increased from 61.5 preoperatively to 84.9 at the final follow-up. The mean AOFAS score of group 1 increased from 60.3 preoperatively to 78.0 (p=0.007) at the final follow-up, and the mean AOFAS score of group 2 also increased from 62.2 to 89.1 (p=0.006). The AOFAS score was statistically better in group 2 than in group 1 (p=0.034) at the final follow-up. Conclusion: Autologous osteochondral graft of the OLT yields satisfactory radiologic and clinical outcomes. Especially, better clinical outcome was observed in the group using the anterior arthrotomy approach (group 2) than in the group using the medial malleolar osteotomy approach (group 1).

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참고문헌

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피인용 문헌

  1. 거골의 골연골병변: 자가 골연골 이식술 vol.24, pp.2, 2020, https://doi.org/10.14193/jkfas.2020.24.2.55