Abstract：Objective: To investigate the effect of osteochondral transplantation on lower limb alignment and ankle-knee joint function after talar osteochondral injury (OLTs). Methods: The clinical data of 104 patients with OLTs in our hospital from July 2018 to September 2020 were collected and analyzed retrospectively. According to the surgical plan, they were divided into the control group (n=52) and the observation group (n=52), who underwent microfracture surgery and osteochondral transplantation, respectively. The improvement degree of lower limb alignment, excellent and good rate of ankle joint recovery, complications, and coagulation function indexes [D-dimer (DD), fibrinogen (Fib)] before and after surgery were observed in the two groups, as well as the HSS joint scores, visual analog scale (VAS)scores, AOFAS scores, and gait parameters (normalized stride length, percentage of time supported by the affected foot, cadence). Results: The VAS score of the observation group was lower than that of the control group at 6 months and 12 months after surgery, and the HSS, AOFAS scores, standardized stride length, stride frequency, and the percentage of foot support time in the observation group were higher than those in the control group (P<0.05); The levels of DD and Fib in the two groups at 3 days after operation were higher than those before operation (P<0.05), and there was no significant difference in the levels of DD and Fib between the two groups at 3 days and 7 days after the operation (P>0.05); At 12 months after the operation, the improvement of lower limb alignment and the excellent and good rate of ankle joint recovery in the observation group were better than those in the control group (P<0.05); There was no significant difference in the incidence of complications between the two groups at 12 months after operation (P>0.05). Conclusion: Osteochondral grafting helps to improve lower limb force lines and gait parameters and restore ankle and knee function in patients with OLTs, with less impact on coagulation function.
赵振拴, 李军, 于晓光, 刘国彬, 赵峰. 骨软骨移植术对距骨骨软骨损伤术后凝血功能步态参数下肢力线的影响[J]. 河北医学, 2023, 29(2): 323-328.
ZHAO Zhenshuan, LI Jun, YU Xiaoguang, et al. Effect of Osteochondral Grafting on Coagulation Function Gait Parameters and Lower Limb Force Lines after Osteochondral Injury of the Talus. HeBei Med, 2023, 29(2): 323-328.
[1] Rikken QGH,Kerkhoffs GMMJ.Osteochondral lesions of the talus:an individualized treatment paradigm from the amsterdam perspective[J].Foot Ankle Clin,2021,26(1):121-136. [2] Aldawsari K,Alrabai HM,Sayed A,et al.Role of particulated juvenile cartilage allograft transplantation in osteochondral lesions of the talus:a systematic review[J].Foot Ankle Surg,2021,27(1):10-14. [3] Li S,Lu R,Zhang J,et al.Outcomes of arthroscopic bone graft transplantation for Hepple stage V osteochondral lesions of the talus[J].Ann Transl Med,2021,9(10):884. [4] 冯利君,张允帅,王宸,等.基质金属蛋白酶-1 mRNA、A-2巨球蛋白mRNA在创伤性关节炎病人软骨中的表达及与病情严重程度的相关性[J].安徽医药,2021,25(6):1208-1211. [5] 谭震,秦澎湃,田磊,等.切开挂线与切开引流对高位马蹄型肛周脓肿的疗效及对患者VAS评分和并发症的影响[J].河北医学,2021,27(5):810-814. [6] 黄一拯,万里洋,徐丹,等.Pilon骨折术后康复中阶梯式踝关节锻炼[J].创伤外科杂志,2020,22(5):363-366. [7] Pereira GF,Steele JR,Fletcher AN,et al.Fresh osteochondral allograft transplantation for osteochondral lesions of the talus:a systematic review[J].Foot Ankle Surg,2021,60(3):585-591. [8] Tosun B.Posteromedial approach for osteochondral lesions of the talus[J].Foot Ankle Int,2021,42(1):17-22. [9] Jackson AT,Drayer NJ,Samona J,et al.Osteochondral allograft transplantation surgery for osteochondral lesions of the talus in athletes[J].Foot Ankle Surg,2019,58(4):623-627. [10] Beth ZC,Sachs B,Kruse D,et al.Arthroscopic implantation of a cartilage matrix for an osteochondral defect of the Talus:a case report[J].Foot Ankle Surg,2019,58(5):1014-1018. [11] Cheng J,Fu Z,Zhu J,et al.The predictive value of plasminogen activator inhibitor-1,fibrinogen,and D-dimer for deep venous thrombosis following surgery for traumatic lower limb fracture[J].Ann Palliat Med,2020,9(5):3385-3392.
2023, Vol. 29 
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