年齢層の異なる距骨骨軟骨病変の特徴

Characteristics of Osteochondral Lesions of the Talus in Different Age Groups.

• Yongxing Cao
• Yang Xu
• Qiang Huang
• Yuan Hong
• Xiangyang Xu

抄録

2014年8月から2019年4月までに当院で距骨骨軟骨病変の手術治療を受けた112例の連続症例の特徴を解析した。患者を若年者（40歳未満）、中年者（40～60歳）、老年者（60歳以上）の3つの年齢群に分けた。基本的な臨床的特徴、病変の局在と大きさ、Hepple病期、手術手技を各群間で比較した。距骨の骨軟骨病変の特徴については、年齢層間でいくつかの有意差が認められた。高齢者では女性の患者が多く（p<0.01）、高齢者では症状の持続期間が長かった（p<0.05）。中高齢者のOLTは距骨の内側に位置することが多く、深さが大きかった(p<0.01)。嚢胞型のHepple stage 5は高齢者群で非常に多かった(p<0.01)。外科的処置については、高齢者群では骨軟骨自家移植が多かった(p<0.01)。60歳以上の患者さんの典型的な特徴は、女性で内側深部距骨軟骨下嚢胞である。距骨軟骨下病変を有する患者の手術方法を選択する際には、年齢は重要な要素であると考えられます。

We analyzed the characteristics of 112 consecutive patients who were operatively treated for osteochondral lesions of the talus from August 2014 to April 2019 in our hospital. The patients were divided into three age groups: young-adult (<40 years), middle-age (40-60 years) and old-age (>60 years). The basic clinical features, localization and size of the lesions, Hepple stage, and surgical procedures were compared among groups. Several significant differences were found on the characteristics of osteochondral lesions of the talus among age groups. There were more female patients in the old-age group (p<0.01), and old patients had a longer duration of symptoms (p<0.05). The OLTs in middle- and old-age patients were mostly located in the medial part of the talus with larger depth (p<0.01). Hepple stage 5, the cystic type, was very common in the old-age group (p<0.01). With regard to surgical procedures, more osteochondral autograft transplantations were applied in the old-age group (p<0.01). Female and deep medial talar subchondral cyst is the typical characteristics of patients over 60 years old. Age is an important factor that must be considered when choosing surgery procedure for patients with osteochondral lesions of the talus.

© Georg Thieme Verlag KG Stuttgart · New York.