自体骨膜游离移植修复髌骨全层软骨缺损的初步观察

作者于１９９１年２月～１９９３年５月，用自体骨膜游离移植修复６例髌骨软骨软化症病人的７侧髌骨和１侧股骨髁共８处大面积全层软骨缺损，患者平均年龄４３．５岁，病程平均７年，软骨缺损面积为１．５ｃｍ×１．２ｃｍ～４．１ｃｍ×２．３ｃｍ。手术用膝前内侧“Ｓ”形切口，探查和处理关节内病变后，将髌骨病变区残存软骨清除，去除软骨下钙化层骨质，露出松质骨，修理平整，切取同侧胫骨近段前外侧骨膜做游离移植修复。术后用长腿石膏伸膝位固定，５～７天后开始关节被动和自动活动，８～１２周后负重行走。术后平均随访３．５年，６例７侧手术，优６侧，良１侧，疗效满意。作者认为用自体骨膜游离移植修复髌骨和股骨髁大面积全层软骨缺损，可取得满意效果，有较大应用价值。

The Preliminary Observation of Chondromalacia of Patella Treated by Free Auto periosteal Grafts

From February 1991 to March 1993, 6 patients with chondromalacia of patella were treated with free auto periosteal grafts . Of 6 cases, 1 case was bilaterally involved; 2 cases were associated with intra articular loose bodies and 4 cases had osteoarthritis. A large area of damaged cartilage of the opposite femoral condyle was seen in 1 case. The average age of patients was 43.5 years and the duration of illness persisted from 1 month to 14 years with an average of 7 years. The full thickness defects of articular cartilage among these cases varied from minimum of 1. 5/1.2 cm and a maximum of 4.1/2.3 cm. The follow up period ranged from 1 to 4 years; 5 cases achieved excellent results and 1 case fair. The author concluded that the transplantation of free auto periosteal grafts can lead to excellent results and is valuable in the treatment of chondromalacia of patella.