Resultado funcional de la reparación del cartílago articular de rodilla …(Ing)

"Resultado funcional de la reparación del cartílago articular de rodilla en atletas adolescentes."

Kai Mithöfer, MD*,,, Tom Minas, MD,,, Lars Peterson, MD, PhD||, Howard Yeon, MD*,, and Lyle J. Micheli, MD*,

From the * Department of Orthopedic Surgery, Children’s Hospital, Boston, Massachusetts, Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts, Harvard Medical School, Boston, Massachusetts, and || Gothenburg Medical Center, Gothenburg, Sweden

Background: Limited information exists about the treatment of full-thickness articular cartilage lesions of the knee in adolescent athletes.

Purpose: To evaluate the functional outcome and athletic activity after articular cartilage repair in the knees of adolescent athletes.

Study Design: Case series; Level of evidence, 4.

Methods: Twenty adolescent athletes with full-thickness articular cartilage lesions of the knee were treated with autologous chondrocyte transplantation. Functional outcome was evaluated by subjective patient outcome rating, knee activity scores, and level of athletic participation.

Results: At a mean of 47 months after autologous chondrocyte transplantation, 96% of adolescents reported good or excellent results with significant increases in postoperative Tegner activity scores and Lysholm scores. Ninety-six percent returned to high-impact sports and 60% to an athletic level equal or higher than that before knee injury. Return to preinjury sports correlated with shorter preoperative symptoms and a lower number of prior operations. All adolescents with preoperative symptoms 12 months returned to preinjury-level athletics, compared to 33% with preoperative intervals longer than 12 months.

Conclusion: Treatment of full-thickness articular injuries of the knee in adolescent athletes with autologous chondrocyte transplantation yields a high rate of functional success at a mean follow-up of 47 months. The rate of return to demanding athletic activities is higher in cases in which the preoperative duration of symptoms is 12 months or less.

The American Journal of Sports Medicine 33:1147-1153 (2005).