Irha E, Vrdoljak J
Department of Orthopedics, Children's Hospital Zagreb, Croatia.
Knee Surg Sports Traumatol Arthrosc. 2000;8(2):99-103. doi: 10.1007/s001670050194.
The aim of this study was to select children with pathological lesions of the intra-articular structures from children with identical complaints but with no pathological intra-articular changes. The younger the child, the more difficult it is to make the diagnosis, and the expected distribution of pathology changes increasingly. This is particularly stressed in children aged younger than 13 years. Synovial inflammatory alterations are more frequent, and osteochondral and chondral fractures appear to be more problematic than meniscal and cruciate ligament lesions. Before establishing the indication for knee arthroscopy it is mandatory to implement the algorithm of diagnostic and conservative therapeutic procedures. The indication for knee arthroscopy is considered in cases when complaints persist after conservative treatment, a lesion of intra-articular segments is suspected, and the pathological condition is deemed arthroscopically treatable. Arthroscopy before conservative treatment is justified only in acute cases.
本研究的目的是从有相同主诉但关节内无病理改变的儿童中挑选出关节内结构有病理病变的儿童。儿童年龄越小，诊断越困难，病理改变的预期分布也越复杂。这在13岁以下的儿童中尤为突出。滑膜炎症改变更为常见，与半月板和交叉韧带损伤相比，骨软骨和软骨骨折似乎更成问题。在确定膝关节镜检查的适应证之前，必须实施诊断和保守治疗程序的算法。当保守治疗后症状持续、怀疑关节内节段有病变且病理状况被认为可通过关节镜治疗时，考虑膝关节镜检查的适应证。仅在急性病例中，保守治疗前的关节镜检查才是合理的。
