Arshi Armin, Wang Dean, Jones Kristofer J
Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
Arthrosc Tech. 2016 Oct 10;5(5):e1149-e1154. doi: 10.1016/j.eats.2016.06.008. eCollection 2016 Oct.
Successful management of patellar osteochondral lesions has proved difficult, with unreliable outcomes reported using traditional cartilage repair and restoration procedures. Unique considerations for this type of defect include the multiplanar contours of the articular surface of the patella, high compressive and shear forces with knee range of motion that may disrupt graft healing, and the potential need for concomitant surgery to address patellar malalignment and instability. We describe our preferred method for treatment of a symptomatic chondral defect in the setting of recurrent patellar instability using particulated juvenile articular cartilage allograft transplantation and medial patellofemoral ligament reconstruction with semitendinosus allograft. Distinct advantages of this cartilage restoration technique include single-stage restoration of relevant cartilage pathology and the ability to easily contour the graft to the size and shape of the chondral defect.
事实证明，髌骨骨软骨损伤的成功治疗颇具难度，采用传统软骨修复和重建手术的疗效并不稳定。这类缺损的独特考量因素包括髌骨关节面的多平面轮廓、膝关节活动时产生的高压缩力和剪切力（可能会干扰移植物愈合），以及可能需要同时进行手术来解决髌骨排列不齐和不稳定的问题。我们描述了在复发性髌骨不稳定情况下，使用颗粒状青少年关节软骨同种异体移植和半腱肌同种异体移植重建髌股内侧韧带，来治疗有症状软骨缺损的首选方法。这种软骨修复技术的显著优势包括对相关软骨病变进行单阶段修复，以及能够轻松地将移植物修整成与软骨缺损大小和形状相符的形态。
