Long-term results of reconstructing the joints' articular surface in the knee and ankle with the surgical diamond instrumentation (SDI).

Autor: Rollmann MF; Department of Trauma, Hand and Reconstructive Surgery, Saarland University, 66421, Homburg, Saar, Germany. mika.rollmann@uks.eu., Herath SC; Department of Trauma, Hand and Reconstructive Surgery, Saarland University, 66421, Homburg, Saar, Germany., Histing T; Department of Trauma, Hand and Reconstructive Surgery, Saarland University, 66421, Homburg, Saar, Germany., Braun BJ; Department of Trauma, Hand and Reconstructive Surgery, Saarland University, 66421, Homburg, Saar, Germany., Schmalenbach J; Department of Trauma, Hand and Reconstructive Surgery, Saarland University, 66421, Homburg, Saar, Germany., Draenert Y; Center of Orthopaedic Research, Gabriel-Max-Str. 3, 81545, München, Germany., Draenert K; Center of Orthopaedic Research, Gabriel-Max-Str. 3, 81545, München, Germany., Pohlemann T; Department of Trauma, Hand and Reconstructive Surgery, Saarland University, 66421, Homburg, Saar, Germany.
Jazyk: angličtina
Zdroj: European journal of trauma and emergency surgery : official publication of the European Trauma Society [Eur J Trauma Emerg Surg] 2021 Oct; Vol. 47 (5), pp. 1627-1634. Date of Electronic Publication: 2020 Feb 21.
DOI: 10.1007/s00068-020-01318-z
Abstrakt: Purpose: The surgical diamond instrumentation (SDI), a precise wet-grinding technology, promised contact healing of press-fit inserted bone and even hyaline cartilage, lacks medium- and long-term results. This retrospective study was conducted to identify risk factors associated with the failure of the technique and the subjective patient outcome.
Methods: All patients treated for cartilage defects of the knee or ankle joint using the SDI technology between 2000 and 2012 with a follow-up > 1 year were included. Patients with general joint diseases or joint-related procedures, except for corrective osteotomies, were excluded. A standardized questionnaire (EQ-5D) and a questionnaire-based patient-reported outcome survey were used. Descriptive statistics were applied. A multivariate analysis examining risk factors for joint failure was performed. A p value < 0.05 was considered to indicate significant differences.
Results: 87 patients with autologous osteochondral transplantation (68 knee, 19 ankle) were included. The median age was 53 years (IQR 37.5-63.0 years) for knee and 36 years (IQR 27.5-54.0 years) for ankle joints. 57.9% of knee and 55.6% of ankle patients were female. Nine patients (8 knee, 1 ankle) had received arthroplasty. 93.3% of knee and 83.3% of ankle patients had an excellent function or minor disabilities. 73.3% of knee and 64.7% of ankle patients did not require pain medication. The mean EQ-5D score was 0.84 for knee and 0.77 for ankle. Patients with higher age were more likely to receive arthroplasty (p = 0.022).
Conclusions: The SDI technique provides promising results with excellent joint survival rates and satisfying patient-reported outcomes. Failure of the technique might be associated with higher age.
(© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: