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广泛关节镜下软骨成形术治疗多发性骨骺发育不良患者股骨髁软骨增生导致的复发性膝关节绞锁

Extensive Arthroscopic Chondroplasty for Cartilage Hyperplasia of the Femoral Condyle Causing Recurrent Knee Locking in a Patient With Multiple Epiphyseal Dysplasia.

作者信息

Koch Jonathan E J, Mann Gideon, Hetsroni Iftach

机构信息

Department of Orthopedic Surgery, Meir General Hospital, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Arthrosc Tech. 2016 Mar 3;5(2):e229-34. doi: 10.1016/j.eats.2015.11.006. eCollection 2016 Apr.

Abstract

Multiple epiphyseal dysplasia is a genetically heterogeneous group of diseases causing altered enchondral ossification. It may affect the knee, among other joints, with variable clinical manifestations. In this report, we present a case of a young adult patient with multiple epiphyseal dysplasia, presenting recurrent catching and locking of the knee due to hyperplastic irregular cartilage. Although radiographs and magnetic resonance imaging of his knee were inconclusive with regard to the source of symptoms, arthroscopic examination revealed a flap of irregular and extensive hypertrophic cartilage of the medial femoral condyle that was causing catching during knee motions. This was treated by extensive arthroscopic resection of the hypertrophic cartilage with the knee held in a deep flexion position and symptoms resolved uneventfully. The case emphasizes the importance of a thorough arthroscopic examination when radiographs and magnetic resonance imaging may overlook the specific source for symptoms, and shows the potential for symptom resolution by arthroscopic intervention in these unusual circumstances.

摘要

多发性骨骺发育不良是一组由软骨内成骨改变引起的具有遗传异质性的疾病。除其他关节外,它可能会影响膝关节,临床表现多样。在本报告中,我们介绍了一例患有多发性骨骺发育不良的年轻成年患者,该患者因增生性不规则软骨导致膝关节反复出现卡顿和交锁。尽管其膝关节的X线片和磁共振成像对于症状来源的诊断不明确,但关节镜检查发现股骨内侧髁有一片不规则且广泛增生的软骨瓣,在膝关节活动时引起卡顿。通过在膝关节极度屈曲位进行广泛的关节镜下增生软骨切除术进行治疗,症状顺利缓解。该病例强调了在X线片和磁共振成像可能忽略症状的具体来源时,进行全面关节镜检查的重要性,并显示了在这些特殊情况下通过关节镜干预缓解症状的可能性。

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本文引用的文献

1
Multiple epiphyseal dysplasia.多发性骨骺发育不良
J Am Acad Orthop Surg. 2015 Mar;23(3):164-72. doi: 10.5435/JAAOS-D-13-00173. Epub 2015 Feb 9.

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