Alford J Winslow, Cole Brian J
Shoulder and Sports Medicine Division, West Bay Orthopedics, Warwick, Rhode Island, USA.
Am J Sports Med. 2005 Feb;33(2):295-306. doi: 10.1177/0363546504273510.
Surgical procedures designed to treat focal chondral lesions are evolving and are supported by basic science principles of cartilage physiology and known responses to injury. Selecting the proper treatment algorithm for a particular patient depends on careful patient evaluation, including the recognition of comorbidities such as ligamentous instability, deficient menisci, or malalignment of the mechanical limb axis or extensor mechanism. These comorbidities may need to be treated in conjunction with symptomatic chondral injuries to provide a mutually beneficial effect. A central tenet of cartilage restoration is to leave future treatment options available should they become necessary. In this article (part 1), the authors review the basic science of chondral injuries, the historical perspective of the available surgical options, and present guidelines for patient evaluation and treatment.
旨在治疗局灶性软骨损伤的外科手术正在不断发展，并得到软骨生理学基础科学原理以及已知损伤反应的支持。为特定患者选择合适的治疗方案取决于对患者的仔细评估，包括识别合并症，如韧带不稳定、半月板缺损或机械性肢体轴线或伸肌机制排列不齐。这些合并症可能需要与有症状的软骨损伤一并治疗，以产生互利的效果。软骨修复的一个核心原则是在必要时保留未来的治疗选择。在本文（第1部分）中，作者回顾了软骨损伤的基础科学、现有手术选择的历史背景，并提出了患者评估和治疗指南。
