RESUMO
PURPOSE: To evaluate the results of autologous chondrocyte implantation with a concomitant injury. MATERIALS AND METHODS: Sixty-seven chondral defects (39 cases, 36 patients), which were treated with autologous chondrocyte implantation, were analyzed with a minimum follow-up of 2 years. The cases were divided into the following five groups: 4 cases of a single chondral defect (group I), 3 cases of multiple chondral defects (group II), 5 cases of osteochondritis dissecans (group III), 9 cases of a single chondral defect with a concomitant injury (group IV), and 18 cases of multiple chondral defects with a concomitant injury (group V). The clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) subjective and objective scores and the International Cartilage Repair Society (ICRS) functional evaluation system. Arthroscopic examinations were performed on 12 cases and 21 chondral defects. RESULTS: The mean IKDC subjective score was 39.8 preoperatively, which improved to 64.1 postoperatively, and the IKDC objective score was C in 54% and D in 46%, which improved to A in 74%, B in 23% and C in 3%. The ICRS functional evaluation system was III in 82% of cases, and IV in 18% preoperatively, which improved to I in 15% and II in 85%, postoperatively. At the arthroscopic evaluation, the results of the ICRS system were I in 9%, II in 67%, and III in 24%. There was no significant difference between the single chondral defect and chondral defects with a concomitant injury. CONCLUSION: In the treatment of the multiple chondral defects with a concomitant injury, autologous chondrocyte implantation produced similar excellent clinical results to those of a single chondral defect.
Assuntos
Cartilagem , Condrócitos , Seguimentos , Joelho , Osteocondrite DissecanteRESUMO
PURPOSE: To analyze clinical, radiological results and survival rates of Press Fit Condylar total knee arthroplasty and compare the results of cruciate-retaining versus cruciate-substitution, and cement versus cementless fixation. MATERIALS AND METHODS: We analyzed 364 patients, 520 knees, which had undergone PFC total knee arthroplasty during the period January 1988 to January 1999. Average follow-up period was 7.1 years (3-14 years). Cases were divided into 2 categories: cruciate-retaining (CR) versus substitution (CS) and cement versus cementless fixation. The clinical results were evaluated using the Hospital for Special Surgery knee scoring system and radiological results were obtained by measuring tibiofemoral angle using Bauer's method. Survivorship analysis was performed using Kaplan-Meier method with revision for any reason as the end point. RESULTS: Clinical, radiological results and the survival rate in the cruciate substitution group were slightly better than those of the cruciate retaining group but no statistical difference was found. Survival rate in the cemented group was significantly higher than that in the cementless group. Clinical and radiological results of the cemented group were better but there was no statistical significance between the two groups. CONCLUSION: No differences were found in the postoperative results of the CR and CS groups. Survival rate in the cemented group was superior to that of the cementless group, which was used even in good bone stock and less deformed cases. This results may be related to a design problem of the cementless prosthesis.