Wilk Kevin E, Briem Kristin, Reinold Michael M, Devine Kathleen M, Dugas Jeffrey, Andrews James R
Benchmark Medical Inc, Malvern, PA, USA.
J Orthop Sports Phys Ther. 2006 Oct;36(10):815-27. doi: 10.2519/jospt.2006.2303.
Articular cartilage lesions of the knee joint are common in patients of varying ages. Some articular cartilage lesions are focal lesions located on one aspect of the tibiofemoral or patellofemoral joint. Other lesions can be extremely large or involve multiple compartments of the knee joint and these are often referred to as osteoarthritis. There are numerous potential causes for the development of articular cartilage lesions: joint injury (trauma), biomechanics, genetics, activities, and biochemistry. Numerous factors also contribute to symptomatic episodes resulting from lesions to the articular cartilage: activities (sports and work), joint alignment, joint laxity, muscular weakness, genetics, dietary intake, and body mass index. Athletes appear to be more susceptible to developing articular cartilage lesions than other individuals. This is especially true with specific sports and subsequent to specific types of knee injuries. Injuries to the anterior cruciate ligament and/or menisci may increase the risk of developing an articular cartilage lesion. The treatment for an athletic patient with articular cartilage lesions is often difficult and met with limited success. In this article we will discuss several types of knee articular cartilage injuries such as focal lesions, advanced full-thickness lesions, and bone bruises. We will also discuss the risk factors for developing full-thickness articular cartilage lesions and osteoarthritis, and describe the clinical evaluation and nonoperative treatment strategies for these types of lesions in athletes.
膝关节软骨损伤在不同年龄段的患者中都很常见。一些关节软骨损伤是位于胫股关节或髌股关节某一侧的局灶性损伤。其他损伤可能非常大或累及膝关节的多个腔室，这些通常被称为骨关节炎。关节软骨损伤的发生有许多潜在原因：关节损伤（创伤）、生物力学、遗传学、活动和生物化学。许多因素也会导致关节软骨损伤引发症状：活动（运动和工作）、关节对线、关节松弛、肌肉无力、遗传学、饮食摄入和体重指数。运动员似乎比其他个体更容易发生关节软骨损伤。在特定运动以及特定类型的膝关节损伤后尤其如此。前交叉韧带和/或半月板损伤可能会增加发生关节软骨损伤的风险。对于患有关节软骨损伤的运动员患者，治疗通常很困难且效果有限。在本文中，我们将讨论几种类型的膝关节软骨损伤，如局灶性损伤、晚期全层损伤和骨挫伤。我们还将讨论发生全层关节软骨损伤和骨关节炎的风险因素，并描述运动员中这些类型损伤的临床评估和非手术治疗策略。
