Hanna S A, Aston W J S, Gikas P D, Briggs T W R
Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK.
J Bone Joint Surg Br. 2008 Feb;90(2):232-5. doi: 10.1302/0301-620X.90B2.19705.
We describe two cases of osteochondritis dissecans (OCD) affecting both femoral condyles in the same knee. The patients presented with recurrent episodes of pain and swelling, but these were initially thought to be 'growing pains'. Eventually, a delayed diagnosis of bicondylar OCD was established and both patients were referred for further management. After assessing the extent of the disease on MRI, matrix-induced autologous chondrocyte implantation was performed to treat the defects of the lateral condyle in each case, with a plan to address the medial defects at a later stage. Proposed theories on the aetiology of the condition and available methods of treatment are discussed. A diagnosis of OCD should be considered in young patients with persistent knee pain and effusions, and MRI is the investigation of choice for early detection.
我们描述了两例膝关节双髁骨软骨炎剥脱症(OCD)的病例。患者表现为反复的疼痛和肿胀发作,但最初被认为是“生长痛”。最终,确诊为双髁OCD,两名患者均被转诊接受进一步治疗。在通过磁共振成像(MRI)评估疾病程度后,对每例患者均进行了基质诱导自体软骨细胞植入术以治疗外侧髁的缺损,并计划在后期处理内侧缺损。文中讨论了关于该病症病因的现有理论及可用的治疗方法。对于有持续性膝关节疼痛和积液的年轻患者,应考虑OCD的诊断,而MRI是早期检测的首选检查方法。