, 1611W. Harrison St, Chicago, IL, 60612, USA,
Curr Rev Musculoskelet Med. 2013 Jun;6(2):102-14. doi: 10.1007/s12178-013-9156-0.
Osteochondritis dissecans of the knee primarily affects subchondral bone, with a secondary effect on the overlying articular cartilage. This process can lead to pain, effusions, and loose body formation. While stable juvenile lesions often respond well to nonoperative management, unstable juvenile lesions, as well as symptomatic adult lesions, often require operative intervention. Short-term goals focus on symptomatic relief, while long-term expectations include the hope of preventing early-onset arthritis. Surgical options include debridement, loose body removal, microfracture, arthroscopic reduction and internal fixation, subchondral drilling, osteochondral autograft or allograft transplantation, and autologous chondrocyte implantation. Newer single-stage cell-based procedures have also been developed, utilizing mesenchymal stem cells and matrix augmentation. Proper treatment requires evaluation of both lesional (size, depth, stability) and patient (age, athletic level) characteristics.
膝关节剥脱性骨软骨炎主要影响软骨下骨，其次影响覆盖的关节软骨。这个过程会导致疼痛、渗液和游离体形成。稳定的青少年病变通常对非手术治疗反应良好，而不稳定的青少年病变和有症状的成人病变通常需要手术干预。短期目标侧重于症状缓解，而长期期望包括预防早期关节炎的发生。手术选择包括清创、游离体去除、微骨折、关节镜下复位和内固定、软骨下钻孔、骨软骨自体或同种异体移植以及自体软骨细胞移植。新的单阶段基于细胞的程序也已开发出来，利用间充质干细胞和基质增强。适当的治疗需要评估病变（大小、深度、稳定性）和患者（年龄、运动水平）的特征。
