Spennacchio Pietro, Randelli Pietro, Arrigoni Paolo, van Dijk Niek
IRCCS Policlinico San Donato Milanese, Milan, Italy.
Arthrosc Tech. 2013 Apr 12;2(2):e129-33. doi: 10.1016/j.eats.2013.01.001. Print 2013 May.
Osteochondral defects (OCDs) of the talus are a common cause of residual pain after ankle injuries. When conservative treatment fails, arthroscopic debridement combined with drilling/microfracturing of the lesion (bone marrow stimulation [BMS] procedures) has been shown to provide good to excellent outcomes. Not uncommonly, talar OCDs involve the borders of the talar dome. These uncontained lesions are sometimes difficult to visualize with the 30° arthroscope, with potential negative effect on the clinical outcome of an arthroscopic BMS procedure. The use of the 70° arthroscope has been described for a multitude of common knee, shoulder, elbow, and hip procedures. The purpose of this article is to show the usefulness of the 70° arthroscope in arthroscopic BMS procedures, pointing out which kinds of talar OCDs can benefit most from its use.
距骨骨软骨损伤(OCDs)是踝关节损伤后残留疼痛的常见原因。当保守治疗失败时,关节镜下清创联合病变部位钻孔/微骨折(骨髓刺激[BMS]手术)已被证明能取得良好至极佳的效果。距骨OCDs累及距骨穹窿边缘的情况并不少见。这些未封闭的损伤有时难以用30°关节镜观察到,这可能会对关节镜下BMS手术的临床效果产生负面影响。70°关节镜已被用于多种常见的膝关节、肩关节、肘关节和髋关节手术。本文旨在展示70°关节镜在关节镜下BMS手术中的作用,指出哪种类型的距骨OCDs最能从其使用中获益。