Heyworth Benton E, Edmonds Eric W, Murnaghan M Lucas, Kocher Mininder S
Division of Sports Medicine, Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Division of Orthopedic Surgery, Rady Children's Hospital, 3030 Children's Way, San Diego, CA 92123, USA; Department of Orthopedic Surgery, University of California San Diego, 200 West Arbor Drive, CA 92103, USA.
Clin Sports Med. 2014 Apr;33(2):305-12. doi: 10.1016/j.csm.2013.11.007. Epub 2014 Feb 18.
Although the advanced stages of osteochondritis dissecans remain challenging to treat, most early-stage lesions in skeletally immature patients, if managed appropriately, can be stimulated to heal. For stable lesions that do not demonstrate adequate healing with nonoperative measures, such as activity modification, weight-bearing protection, or bracing, drilling of the subchondral bone has emerged as the gold standard of management. Several techniques of drilling exist, including transarticular drilling, retroarticular drilling, and notch drilling. Although each technique has been shown to be effective in small retrospective studies, higher-powered prospective comparative studies are needed to better elucidate their relative advantages and disadvantages.
尽管剥脱性骨软骨炎的晚期治疗仍具有挑战性，但大多数骨骼未成熟患者的早期病变，如果处理得当，可刺激其愈合。对于采用非手术措施（如调整活动、负重保护或支具固定）后未显示出充分愈合的稳定病变，软骨下骨钻孔已成为治疗的金标准。钻孔技术有多种，包括经关节钻孔、关节后钻孔和切迹钻孔。尽管每项技术在小型回顾性研究中均显示有效，但仍需要更高质量的前瞻性对比研究，以更好地阐明它们的相对优缺点。
