PDF(Pubmed)
Abstract：
OBJECTIVE: Focal chondral lesions of the femur are currently treated with biological repair or arthroplasty. However, some patients are not suitable for either one due to lesion size, age, or prior biological treatment attempts. While singular patient-specific focal mini metal implants already showed good results, the outcomes of bicompartmental implantation of these implants have not been discussed in the literature yet. This study aims to evaluate clinical outcomes of patients who underwent bicompartmental implantation of two patient-specific implants.
METHODS: This prospective, non-randomized, non-comparative pilot study evaluates results up to two years after bicompartmental implantation of two implants (Episealer Implant, Episurf, Stockholm, Sweden). A damage report is compiled using a special MRI program and patient specific implants are manufactured, including 3D-printed surgical instruments to provide exact placement of the implant. The patients were assessed repeatedly using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Visual Analogue Scale (VAS) for pain during the follow-up.
RESULTS: The scores were evaluated three, 12, and 24 months after surgery and showed good results. The median in both scores improved from 37.7 for the KOOS5 preoperatively to 69.1 after 24 months and from 69 for the VAS for pain preoperatively to 9 after 24 months.
CONCLUSIONS: Overall, for the small study group presented, the early results are promising. With noticeable improvement in KOOS and VAS for pain after two years, patient specific implants appear to become relevant in future standardized treatment of femoral chondral lesions. Especially with bicompartmental implantation, full arthroplasty can be delayed even further.
METHODS: IV.
METHODS: This prospective, non-randomized, non-comparative pilot study evaluates results up to two years after bicompartmental implantation of two implants (Episealer Implant, Episurf, Stockholm, Sweden). A damage report is compiled using a special MRI program and patient specific implants are manufactured, including 3D-printed surgical instruments to provide exact placement of the implant. The patients were assessed repeatedly using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Visual Analogue Scale (VAS) for pain during the follow-up.
RESULTS: The scores were evaluated three, 12, and 24 months after surgery and showed good results. The median in both scores improved from 37.7 for the KOOS5 preoperatively to 69.1 after 24 months and from 69 for the VAS for pain preoperatively to 9 after 24 months.
CONCLUSIONS: Overall, for the small study group presented, the early results are promising. With noticeable improvement in KOOS and VAS for pain after two years, patient specific implants appear to become relevant in future standardized treatment of femoral chondral lesions. Especially with bicompartmental implantation, full arthroplasty can be delayed even further.
METHODS: IV.
摘要：
目的：股骨局灶性软骨损伤目前采用生物修复或关节成形术治疗。然而,一些患者由于病变大小不适合任何一种，年龄,或先前的生物治疗尝试。虽然针对患者的单一局部微型金属植入物已经显示出良好的效果，文献中还没有讨论这些植入物的双室植入的结局.本研究旨在评估接受两种患者特异性植入物的双室植入的患者的临床结果。
方法：这种前瞻性，非随机化，非比较性试点研究评估了两种植入物双室植入后两年内的结果(EpisealerImplant，Episurf,斯德哥尔摩,瑞典)。使用特殊的MRI程序编制损伤报告，并制造患者特定的植入物，包括3D打印的手术器械，以提供植入物的精确放置。在随访期间，使用膝关节损伤和骨关节炎结果评分（KOOS）和视觉模拟评分（VAS）反复评估患者的疼痛。
结果：评分为3，术后12个月和24个月均显示良好的效果。两个评分的中位数从KOOS5术前的37.7分提高到24个月后的69.1分，从疼痛的VAS术前的69分提高到24个月后的9分。
结论：总体而言，对于提出的小型研究小组，早期的结果是有希望的。两年后，KOOS和VAS的疼痛明显改善，患者特异性植入物似乎在未来股骨软骨病变的标准化治疗中变得相关。尤其是双室植入，全关节成形术可以进一步延迟。
方法：IV.
方法：这种前瞻性，非随机化，非比较性试点研究评估了两种植入物双室植入后两年内的结果(EpisealerImplant，Episurf,斯德哥尔摩,瑞典)。使用特殊的MRI程序编制损伤报告，并制造患者特定的植入物，包括3D打印的手术器械，以提供植入物的精确放置。在随访期间，使用膝关节损伤和骨关节炎结果评分（KOOS）和视觉模拟评分（VAS）反复评估患者的疼痛。
结果：评分为3，术后12个月和24个月均显示良好的效果。两个评分的中位数从KOOS5术前的37.7分提高到24个月后的69.1分，从疼痛的VAS术前的69分提高到24个月后的9分。
结论：总体而言，对于提出的小型研究小组，早期的结果是有希望的。两年后，KOOS和VAS的疼痛明显改善，患者特异性植入物似乎在未来股骨软骨病变的标准化治疗中变得相关。尤其是双室植入，全关节成形术可以进一步延迟。
方法：IV.
