Kivistö R, Pasanen L, Leppilahti J, Jalovaara P
Division of Orthopedic of Surgery, University of Oulu, Kajaanintie 52, 90220 Oulu, Finland.
Knee Surg Sports Traumatol Arthrosc. 2002 Sep;10(5):305-9. doi: 10.1007/s00167-002-0294-y. Epub 2002 May 8.
In a retrospective clinical study we evaluated the outcome of arthroscopic repair of osteochondritis dissecans (OCD) of the femoral condyles with metal stable fixation. Twenty-eight knees of 26 patients (mean age 20 years) with OCD of the knee were treated by fixation of the fragments with Hoffmann's dynamic metal staples arthroscopically and by additional arthrotomy in 7 knees. At follow-up (mean 4 years, 1-7) patients were interviewed for any residual symptoms and underwent a routine clinical and radiographic examination. The clinical results were based on the grading scale of Lysholm. The 17 knees which did not require further surgery showed 13 instances of complete healing, 3 of partial healing, and 1 of nonhealing. The 11 knees which had reoperations showed 2 instances of complete healing, 5 of partial healing, and 4 nonhealing. There was no significant difference between early or late surgery, and results were not related significantly to site of the lesion, handling of the fragment and the crater, percutaneous drilling, or type of fragmentation. Clinical grading of 13 knees was as excellent, 11 good, and 4 fair. Broken stables were observed in 9 knees, and they were removed from 5 knees. Complete healing was thus achieved in one-half and partial healing in one-third of cases. The metal staples used here fit for use in the arthroscopic fixation of the OCD of the knee, although the staples had a marked liability to break.
在一项回顾性临床研究中，我们评估了采用金属稳定固定术对股骨髁剥脱性骨软骨炎（OCD）进行关节镜修复的效果。26例（平均年龄20岁）患有膝关节OCD的患者的28个膝关节，通过关节镜下使用霍夫曼动力金属钉固定碎片进行治疗，其中7个膝关节还进行了附加切开手术。在随访时（平均4年，1 - 7年），对患者进行访谈以了解任何残留症状，并进行常规临床和影像学检查。临床结果基于Lysholm评分量表。17个无需进一步手术的膝关节中，有13例完全愈合，3例部分愈合，1例未愈合。11个接受再次手术的膝关节中，有2例完全愈合，5例部分愈合，4例未愈合。早期或晚期手术之间无显著差异，结果与病变部位、碎片和骨坑的处理、经皮钻孔或碎片类型均无显著相关性。13个膝关节的临床分级为优，11个为良，4个为可。9个膝关节出现金属钉断裂，其中5个膝关节的金属钉被取出。因此，一半的病例实现了完全愈合，三分之一的病例实现了部分愈合。尽管这里使用的金属钉有明显的断裂倾向，但仍适用于膝关节OCD的关节镜固定。
