Short-term Therapeutic Effect of Arthroscopic Microfracture Surgery Combined with Oral Glucosamine Hydrochloride on Osteochondritis Dissecans of the Knee_West China Medical Journal

Authors：

 LiuJuncai ,  LiZhong , LiWen , HeKe , ZhangZhiwei , LiRenming , YueYongchuan , HeMingliang

Department of Bone and Joint Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;

Corresponding author：

LiZhong, Email: 545890312@qq.com

Keywords：

Osteochondritis dissecans; Arthroscopy; Microfracture surgery; Glucosamine hydrochloride

DOI：

10.7507/1002-0179.201600324

Video：

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Objective To assess the therapeutic effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride on osteochondritis dissecans of the knee. Methods Between January 2014 and June 2015, 24 patients with osteochondritis dissecans of the knee ready to undergo arthroscopic microfracture surgery were divided into experimental group (odd surgery sequence numbers) treated with arthroscopic microfracture surgery combined with oral glucosamine hydrochloride (480 mg/time, 3 times per day, from the first day to 3 months after the surgery) and control group (even surgery sequence numbers) treated with arthroscopic microfracture surgery. All the patients were discharged from the hospital after one week of rehabilitation exercises with rehabilitation equipment of lower extremity. Follow-up lasted for at least 6 months. The therapeutic effects of the two methods were assessed according to Tegner scores for motor function of knee joint and United States New York specialty surgical hospital (HSS) scores. Results The symptoms of knee joint was alleviated significantly after the operation. The function of knee joint was improved significantly after 6 weeks. Tegner and HSS scores before surgery were not significantly different between the two groups (P>0.05). The Tegner scores were not significantly different between the two groups 6 weeks after surgery (P>0.05). The difference of Tegner scores were statistically significant between the two groups 12 and 24 weeks after surgery (P<0.05), and HSS scores of the experimental group improved better than the control group 6, 12 and 24 weeks after surgery, and the differences were statistically significant (P<0.05). Conclusion The short-term effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride is better than that of arthroscopic microfracture surgery in the treatment of osteochondritis dissecans of the knee.

Citation： LiuJuncai, LiZhong, LiWen, HeKe, ZhangZhiwei, LiRenming, YueYongchuan, HeMingliang. Short-term Therapeutic Effect of Arthroscopic Microfracture Surgery Combined with Oral Glucosamine Hydrochloride on Osteochondritis Dissecans of the Knee. West China Medical Journal, 2016, 31(7): 1189-1192. doi: 10.7507/1002-0179.201600324 Copy

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2.	Bradley J, Dandy DJ. Osteochondritis dissecans and other lesions of the femoral condyles[J]. J Bone Joint Surg Br, 1989, 71(3):518-522.
3.	杨文华, 曹怀民. 关节镜下微骨折术修复膝关节软骨损伤43例临床探讨[J]. 吉林医学, 2013, 34(11):2023-2024.
4.	Flynn JM, Mininder S. Osteochondritis dissecans of the knee[J]. Pediatrics, 2004, 24(4):78-88.
5.	Hefli F, Berguiristain J, KrauspeR, et al. Osteochondritis dissecans:amulticenter study of the European Pediatric Orthopaedic Society[J]. Pediatr Orthop, 1999, 8(4):231-245.
6.	Guhl JF. Arthroscopic treatment of osteochondritis dissecans[J]. Clin Orthop, 1982, 37(8):65-74.
7.	De Smet AA, Ilahi OA, Graf BK. Untreated osteochondritis dissecans of the femoral condyles:prediction of patient outcome using radiographic and Mr findings[J]. Skeletal Radiol, 1997, 26(8):463-467.
8.	Lyon R, Nissen C, Liu XC, et al. Can fresh osteochondral allografts restore function in juveniles with osteochondritis dissecans of the knee?[J]. Clin Orthop Relat Res, 2013, 471(4):1166-1173.
9.	黄迅悟, 冯会成, 孙继桐, 等. 成年人股骨髁剥脱性骨软骨炎的外科治疗[J]. 中华关节外科杂志:电子版, 2013, 7(6):747-750.
10.	Erdil M, Bilsel K, Taser OF, et al. Osteochondral autologous graft transfer system in the knee; mid-term results[J]. Knee, 2013, 20(1):2-8.
11.	Steadman JR, Rodkey WG, Briggs KK, et al. The microfracture technic in the management of complete cartilage defects in the knee joint[J]. Orthopade, 1999, 28(1):26-32.
12.	Sledge SL. Microfracture techniques in the treatment of osteochondral injuries[J]. Clin Sports Med, 2001, 20(2):365-377.
13.	胡志喜, 贺用礼. 关节镜下微骨折术治疗膝关节软骨损伤[J]. 中国现代医生, 2012, 50(35):36-37.
14.	Uitterlinden EJ, Koevoet JL, Verkoelen CF, et al. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants[J]. BMC Musculoskelet Disord, 2008, 9:120.
15.	Bining HJ, Santos R, Andrews G, et al. Can T2 relaxation values and color maps be used to detect chondral damage utilizing subchondral bone marrow edema as a marker?[J]. Skeletal Radiol, 2009, 38(5):459-465.
16.	Irie K, Uchiyama E, Iwaso H. Intraarticular inflammatory cytokines in acute anterior cruciate ligament injured knee[J]. Knee, 2003, 10(1):93-96.
17.	Walsh NC, Crotti TN, Goldring SR, et al. Rheumatic diseases:the effects of inflammation on bone[J]. Immunol Rev, 2005, 208:228-251.
18.	Christiansen BA, Anderson CA, Lee JC, et al. Musculoskeletal changes following non-invasive knee injury using a novel mouse model of post-traumatic osteoarthritis[J]. Osteoarthritis Cartilage, 2012, 20(7):773-782.
19.	Piperno M, Reboul P, Hellio Le Graverand MP, et al. Glucosamine sulfate modulates dysregulated activities of human osteoarthritic chondrocytes in vitro[J]. Osteoarthritis Cartilage, 2000, 8(3):207-212.
20.	Nakamura H, Shibakawa A, Tanaka M, et al. Effects of glucosamine hydrochloride on the production of prostaglandin E2, nitric oxide and metalloproteases by chondrocytes and synoviocytes in osteoarthritis[J]. Clin Exp Rheumatol, 2004, 22(3):293-299.

1. Petersen JP, Steinhagen J, Catala-Lehnen P, et al. Osteochondritis dissecans of the knee joint[J]. Z Orthop Ihre Grenzgeb, 2006, 144(4):R63-R76.
2. Bradley J, Dandy DJ. Osteochondritis dissecans and other lesions of the femoral condyles[J]. J Bone Joint Surg Br, 1989, 71(3):518-522.
3. 杨文华, 曹怀民. 关节镜下微骨折术修复膝关节软骨损伤43例临床探讨[J]. 吉林医学, 2013, 34(11):2023-2024.
4. Flynn JM, Mininder S. Osteochondritis dissecans of the knee[J]. Pediatrics, 2004, 24(4):78-88.
5. Hefli F, Berguiristain J, KrauspeR, et al. Osteochondritis dissecans:amulticenter study of the European Pediatric Orthopaedic Society[J]. Pediatr Orthop, 1999, 8(4):231-245.
6. Guhl JF. Arthroscopic treatment of osteochondritis dissecans[J]. Clin Orthop, 1982, 37(8):65-74.
7. De Smet AA, Ilahi OA, Graf BK. Untreated osteochondritis dissecans of the femoral condyles:prediction of patient outcome using radiographic and Mr findings[J]. Skeletal Radiol, 1997, 26(8):463-467.
8. Lyon R, Nissen C, Liu XC, et al. Can fresh osteochondral allografts restore function in juveniles with osteochondritis dissecans of the knee?[J]. Clin Orthop Relat Res, 2013, 471(4):1166-1173.
9. 黄迅悟, 冯会成, 孙继桐, 等. 成年人股骨髁剥脱性骨软骨炎的外科治疗[J]. 中华关节外科杂志:电子版, 2013, 7(6):747-750.
10. Erdil M, Bilsel K, Taser OF, et al. Osteochondral autologous graft transfer system in the knee; mid-term results[J]. Knee, 2013, 20(1):2-8.
11. Steadman JR, Rodkey WG, Briggs KK, et al. The microfracture technic in the management of complete cartilage defects in the knee joint[J]. Orthopade, 1999, 28(1):26-32.
12. Sledge SL. Microfracture techniques in the treatment of osteochondral injuries[J]. Clin Sports Med, 2001, 20(2):365-377.
13. 胡志喜, 贺用礼. 关节镜下微骨折术治疗膝关节软骨损伤[J]. 中国现代医生, 2012, 50(35):36-37.
14. Uitterlinden EJ, Koevoet JL, Verkoelen CF, et al. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants[J]. BMC Musculoskelet Disord, 2008, 9:120.
15. Bining HJ, Santos R, Andrews G, et al. Can T2 relaxation values and color maps be used to detect chondral damage utilizing subchondral bone marrow edema as a marker?[J]. Skeletal Radiol, 2009, 38(5):459-465.
16. Irie K, Uchiyama E, Iwaso H. Intraarticular inflammatory cytokines in acute anterior cruciate ligament injured knee[J]. Knee, 2003, 10(1):93-96.
17. Walsh NC, Crotti TN, Goldring SR, et al. Rheumatic diseases:the effects of inflammation on bone[J]. Immunol Rev, 2005, 208:228-251.
18. Christiansen BA, Anderson CA, Lee JC, et al. Musculoskeletal changes following non-invasive knee injury using a novel mouse model of post-traumatic osteoarthritis[J]. Osteoarthritis Cartilage, 2012, 20(7):773-782.
19. Piperno M, Reboul P, Hellio Le Graverand MP, et al. Glucosamine sulfate modulates dysregulated activities of human osteoarthritic chondrocytes in vitro[J]. Osteoarthritis Cartilage, 2000, 8(3):207-212.
20. Nakamura H, Shibakawa A, Tanaka M, et al. Effects of glucosamine hydrochloride on the production of prostaglandin E2, nitric oxide and metalloproteases by chondrocytes and synoviocytes in osteoarthritis[J]. Clin Exp Rheumatol, 2004, 22(3):293-299.

West China Medical Journal

Short-term Therapeutic Effect of Arthroscopic Microfracture Surgery Combined with Oral Glucosamine Hydrochloride on Osteochondritis Dissecans of the Knee

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