Yang Justin S, Bogunovic Ljiljana, Wright Rick W
Department of Orthopedics, Washington University, 660 South Euclid MS 8233, St Louis, MO, USA.
Department of Orthopedics, Washington University, 660 South Euclid MS 8233, St Louis, MO, USA.
Clin Sports Med. 2014 Apr;33(2):295-304. doi: 10.1016/j.csm.2013.11.003. Epub 2014 Feb 7.
Osteochondritis dissecans is a potentially devastating cause of knee pain in adolescents and adults. Prognosis and treatment depends on the stability of the lesion and the age of the patient. Skeletally immature patients with stable lesions are amenable for nonoperative treatment. Nonoperative treatment is less predictable in skeletally mature patients and patients with unstable lesions. Lesion size, location, stability along with symptomatology should all be considered before initiating treatment. Modalities of nonoperative treatment can range from activity modification to complete immobilization. Close follow-up is recommended to monitor healing progression and symptom resolution.
剥脱性骨软骨炎是青少年和成人膝关节疼痛的一个潜在严重病因。预后和治疗取决于病变的稳定性以及患者的年龄。骨骼未成熟且病变稳定的患者适合非手术治疗。对于骨骼成熟的患者以及病变不稳定的患者,非手术治疗的可预测性较差。在开始治疗前,应综合考虑病变大小、位置、稳定性以及症状表现。非手术治疗方式可从调整活动到完全固定。建议密切随访以监测愈合进程和症状缓解情况。