COMPARATIVE ANALYSIS OF TREATMENT RESULTS OF OSTEOCHONDRAL DEFECTS OF THE ARTICULAR SURFACE OF THE KNEE JOINT ASSOCIATED WITH DAMAGE TO THE ANTERIOR CRUCIATE LIGAMENT

Abstract

Purpose of work: to perform a comparative analysis of the results of treatment of patients with osteochondral defects of the articular surface associated with damage of the anterior cruciate ligament of the knee joint. Materials and Methods. Between 2015 and 2023 inclusive, 72 patients with anterior cruciate ligament injury accompanied by osteochondral defects of femoral condyles were treated. All patients were randomly divided into three groups: the first group - simultaneous ACL reconstruction and abrasive chondroplasty (ACh-ACL group) (n=24); the second group - ACL reconstruction and microfracturing (MF-ACL group) (n=24); the third group - ACL reconstruction and mosaic autochondroplasty (OAT-ACL group) (n=24). For the purpose of independent evaluation, a control group - anterior cruciate ligament reconstruction with intact articular cartilage (IAC-ACL group) (n=24) was introduced for comparison. Results and Discussion. Having analyzed the results of IKDC-2000 and Lysholm + Tegner questionnaires at 3, 6 and 12 months after the operation we noted the greatest positive dynamics in the early postoperative period (3 months) in all groups. From 6 to 12 months the dynamics changed its tendency and more pronouncedly passed into a "plateau" in groups 1 and 2, which was clinically determined by the restoration of passive movements with insufficient volume of active flexion-extension movements in the knee joint, as well as by the persistence of pain syndrome during loading. Conclusions. Simultaneous reconstruction of osteochondral lesions of the articular surface of the knee joint and reconstruction of the anterior cruciate ligament is the basis for full restoration of the function and bearing capacity of the knee joint. In this case, the use of organ-reconstructive methods of surgical intervention (bone-cartilage autochondroplasty and anterior cruciate ligament reconstruction (OAT-ACL)) allows achieving better clinical results compared to "mesenchymal stimulation" of the defect area, showing full functional recovery of the knee joint.