Rowe Sung Man, Moon Eun Sun, Yoon Taek Rim, Jung Sung Taek, Lee Keun Bae, Lee Jae Joon
Department of Orthopedics, Chonnam National University Hospital, Gwangiu, Korea.
J Bone Joint Surg Br. 2002 Sep;84(7):1025-9. doi: 10.1302/0301-620x.84b7.13227.
The treatment of osteochondritis dissecans after Legg-Calvé-Perthes' disease has not been clearly determined. It may be either by simple observation or surgical removal of the osteochondral fragment. We studied the evolution of the lesion in 13 children and reviewed 92 hips reported in the literature. In our patients ten showed a tendency towards spontaneous healing, one required drilling + grafting to obtain fusion, and in two there was separation into the joint. These loose bodies were in the acetabular fossa and caused no symptoms. On reviewing the literature, we found only four cases of hips with loose bodies from osteochondritis dissecans. These were lying in the inferomedial capsule and were also asymptomatic. Treatment of osteochondritis dissecans after Legg-Calvé-Perthes' disease should therefore be conservative unless the fragment interferes with the mechanics of the hip.
莱-卡-佩病（Legg-Calvé-Perthes' disease）后剥离性骨软骨炎的治疗方法尚未明确确定。治疗方法可能是单纯观察，也可能是手术切除骨软骨碎片。我们研究了13例儿童病变的演变情况，并回顾了文献报道的92例髋关节病例。在我们的患者中，10例有自发愈合的倾向，1例需要钻孔+植骨以实现融合，2例骨碎片进入关节。这些游离体位于髋臼窝，未引起任何症状。在回顾文献时，我们仅发现4例剥离性骨软骨炎导致髋关节出现游离体的病例。这些游离体位于关节囊的内下侧，也没有症状。因此，除非骨碎片影响髋关节力学，莱-卡-佩病后剥离性骨软骨炎的治疗应采取保守治疗。
