دورية أكاديمية
Mid-term outcomes of microfracture for the treatment of focal, full-thickness cartilage defects isolated to the humeral head.
| العنوان: | Mid-term outcomes of microfracture for the treatment of focal, full-thickness cartilage defects isolated to the humeral head. |
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| المؤلفون: | Dey Hazra RO; Steadman Philippon Research Institute, Vail, CO, USA; The Steadman Clinic, Vail, CO, USA., Rutledge JC; Steadman Philippon Research Institute, Vail, CO, USA., Hanson JA; Steadman Philippon Research Institute, Vail, CO, USA., Dey Hazra ME; Steadman Philippon Research Institute, Vail, CO, USA., Horan MP; Steadman Philippon Research Institute, Vail, CO, USA., Doan KC; Steadman Philippon Research Institute, Vail, CO, USA; Department for Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Orthopaedic Sports Medicine, Hospital rechts der Isar, Technical University of Munich, Munich, Germany; Kansas City Orthopedic Alliance, Kansas City, MO, USA., Rupp MC; Steadman Philippon Research Institute, Vail, CO, USA; University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA., Millett PJ; Steadman Philippon Research Institute, Vail, CO, USA; Department for Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. Electronic address: drmillett@thesteadmanclinic.com. |
| المصدر: | Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2024 Sep; Vol. 33 (9), pp. 1972-1979. Date of Electronic Publication: 2024 Feb 14. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mosby Country of Publication: United States NLM ID: 9206499 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-6500 (Electronic) Linking ISSN: 10582746 NLM ISO Abbreviation: J Shoulder Elbow Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: St. Louis, MO : Mosby Original Publication: St. Louis, MO : Mosby Yearbook, Inc., c1992- |
| مواضيع طبية MeSH: | Humeral Head*/surgery , Arthroplasty, Subchondral*/methods , Cartilage, Articular*/surgery , Cartilage, Articular*/injuries, Humans ; Male ; Female ; Adult ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Follow-Up Studies ; Aged ; Patient Reported Outcome Measures ; Shoulder Joint/surgery ; Pain Measurement |
| مستخلص: | Background: While microfracture has been shown to be an effective treatment for chondral lesions in the knee, evidence to support its use for chondral defects in the shoulder is limited to short-term outcomes studies. The purpose of this study is to determine if microfracture provides pain relief and improved shoulder function in patients with isolated focal chondral defects of the humeral head at a minimum 5-year follow-up. Methods: Patients who underwent microfracture procedure for isolated focal chondral defects of the humeral head with a minimum follow-up of 5 years between 02/2006 and 08/2016 were included. At minimum 5-year follow-up, pre- and postoperative patient-reported outcome (PRO) measures were collected, including the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Short Form-12 (SF-12) Physical Component Summary (PCS), Visual Analog Scale (VAS) for pain, and patient satisfaction level (1 = unsatisfied, 10 = very satisfied). Demographic, injury, and surgical data were retrospectively reviewed. Surgical failure was defined as revision surgery for humeral chondral defects or conversion to arthroplasty. Kaplan-Meier analysis was performed to determine survivorship at 5 years. Results: A total of 17 patients met inclusion/exclusion criteria. There were 15 men and 2 women with an average age of 51 years (range 36-69) and an average follow-up of 9.4 years (range 5.0-15.8). The median ASES score improved from 62 (range: 22-88) preoperatively to 90 (range: 50-100) postoperatively (P = .011). Median satisfaction was 8 out of 10 (range: 2-10). There was no correlation between patient age or defect size and PROs. Postoperatively, patients reported significant improvements in recreational and sporting activity as well as the ability to sleep on the affected shoulder (P ≤ .05). Three patients failed and required revision surgery. The Kaplan-Meier analysis determined an overall survivorship rate of 80% at 5 years. Conclusion: The presented study illustrates significant improvements for PROs, improved ability to perform recreational and sporting activities, and a survival rate of 80% at a mean of 9.4 years after microfracture for focal chondral humeral head defects. (Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Shoulder arthroscopy; articular cartilage; cartilage defects; microfracture; shoulder; shoulder surgery |
| تواريخ الأحداث: | Date Created: 20240215 Date Completed: 20240817 Latest Revision: 20240817 |
| رمز التحديث: | 20240818 |
| DOI: | 10.1016/j.jse.2023.12.022 |
| PMID: | 38360353 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1532-6500 |
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| DOI: | 10.1016/j.jse.2023.12.022 |