髌股关节骨软骨同种异体移植显示中短期生存率高但长期结果不一：一项系统综述
简介
这项系统综述纳入7项研究（8–40例，随访24–238.8个月），评估髌股关节同种异体骨软骨移植至少2年随访的疗效。多数为翻修病例，术后IKDC、KOS-ADL等评分显著改善，失败率0%–25%，多因转为关节置换；短中期移植物生存率高，但长期生存率因再手术和转关节置换而差异较大。可为软骨修复提供参考，但纳入研究少、证据等级低。
英文摘要
PURPOSE: To evaluate clinical outcomes, complication and failure rates, and graft survivorship after patellofemoral osteochondral allograft (OCA) transplantation with a minimum follow-up of 2 years. METHODS: A systematic review was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, MEDLINE, and Cochrane databases were queried in June 2025 for English-language human studies on OCA transplantation of the patellofemoral joint with ≥2-year follow-up. Data including patient demographics, lesion characteristics, surgical techniques, prior surgery, outcomes, complications, and failures were extracted. Descriptive statistics were calculated, including mean delta values for reported scores. Study quality was assessed using the modified Coleman Methodology Score and risk of bias with Methodological Index for Non-Randomized Studies criteria in the included studies. RESULTS: A total of 7 studies published between 1990 and 2024 met inclusion criteria, encompassing anywhere from 8 to 40 patients with an age range of 12 to 64 years and follow-up of 24 to 238.8 months. OCA was most frequently performed as a revision procedure, with 57.8% to 100% of patients having undergone at least 1 prior surgery. All studies reported statistically significant improvements (P < .05) in functional outcomes, including International Knee Documentation Committee, Knee Outcome Survey Activities of Daily Living, and modified d'Aubigné-Postel scores. Reported failure rates ranged from 0% to 25%, with most studies citing conversion to arthroplasty as the primary endpoint for failure. CONCLUSIONS: OCA transplantation of the patellofemoral joint showed meaningful improvements in patient-reported outcomes and satisfaction, with high short- to midterm graft survivorship. Long-term graft survivorship was variable because of graft reoperation and conversion arthroplasty. LEVEL OF EVIDENCE: Level IV, systematic review of Level III and IV studies.