Alford J Winslow, Cole Brian J
Shoulder and Sports Medicine Division, West Bay Orthopedics, Warwick, RI, USA.
Am J Sports Med. 2005 Mar;33(3):443-60. doi: 10.1177/0363546505274578.
In part 1 of this 2-part Current Concepts article, the authors reviewed the basic science of normal articular and meniscal cartilage and its response to injury. They reviewed the historical perspectives and basic science behind these various methods and presented a rationale for patient evaluation, treatment selection, and timing. In part 2, the authors review the specific indications for the treatment of chondral injuries and describe the techniques and outcomes of the various treatment options, including palliative, reparative, and restorative procedures. In addition, they will examine specific complex clinical scenarios emphasizing treatment options of comorbid conditions including ligament instability, meniscal deficiency, and malalignment. A limited review of the application of these techniques in joints other than the knee will also be presented. A conceptual algorithm is developed to assist in clinical decision making.
在这篇分两部分的“当前概念”文章的第1部分中，作者回顾了正常关节软骨和半月板软骨的基础科学及其对损伤的反应。他们回顾了这些不同方法背后的历史观点和基础科学，并提出了患者评估、治疗选择和时机选择的基本原理。在第2部分中，作者回顾了软骨损伤治疗的具体适应症，并描述了各种治疗选择的技术和结果，包括姑息性、修复性和恢复性手术。此外，他们将研究特定的复杂临床情况，重点关注合并症的治疗选择，包括韧带不稳定、半月板缺损和排列不齐。还将对这些技术在膝关节以外关节的应用进行有限的综述。开发了一个概念性算法以协助临床决策。
