OUR EXPERIENCE IN THE USE OF BONE-CARTILAGE AUTOPLASTY IN THE TREATMENT OF PATIENTS WITH OSTEOCHONDRAL PATELLAR DEFECTS

Abstract

Objective: to evaluate the effectiveness of bone-cartilage autoplasty in the treatment of patients with osteochondral patellar defects. Materials and methods. The study analyzed the results of surgical treatment of 7 patients for the period from 2012 to 2023 inclusive. All patients underwent inpatient treatment at the Department of Traumatology and Orthopedics No. 2 Clinics of Samara State Medical University (SamSMU). All patients had a defect of patellar cartilage on the background of osteoarthritis of the knee joint with a predominant lesion of the patellofemoral joint (patellofemoral arthrosis). Bone-cartilaginous autoplasty of the articular surface of the patella was used as an operation. Clinical evaluation of treatment results was carried out on the basis of the methods recommended by OARSI (Osteoarthritis Research Society International) before surgery and at 3, 6 and 12 months after surgery: VAS (Visual Analog Scale), WOMAC Index (Western Ontario and McMaster University Osteoarthritis Index) and M. Lequesne algofunctional index were determined. The condition of bone-cartilage tissue in the defect area before surgery and after bone-cartilage autoplasty was assessed using radiography and magnetic resonance imaging. Results and discussion. We noted that according to the studied indices and scales, the greatest positive dynamics was observed in the early postoperative period (3 months), the peak reached by 6 months, and full functional recovery occurred by 12 months (return to sports, high-intensity work). The most complete restructuring as a result of the examination of 7 patients according to radiography and MRI, we noted at the time of 6 months, when we see a complete restructuring of the patellar cartilage tissue, as well as the greatest signs of autograft integration in the subchondral zone. Conclusions. The use of bone-cartilage autoplasty as a method of surgical treatment in patients with osteochondral injuries of the patella in clinical practice is effective, expedient and its use in clinical practice is recommended from the standpoint of restoring the function of the knee joint, which leads to an improvement in the quality of life of patients. Nevertheless, its application requires taking into account all anatomical and functional features of the patellofemoral articulation.