Nuelle Clayton W, Farr Jack
The San Antonio Orthopaedic Group, San Antonio, Texas.
Cartilage Restoration Center, OrthoIndy, Greenwood, Indiana.
J Knee Surg. 2018 Mar;31(3):206-211. doi: 10.1055/s-0037-1607199. Epub 2017 Oct 4.
Osteochondritis dissecans (OCD) lesions of the patellofemoral joint can be difficult to identify and treat. Asymptomatic or stable lesions in skeletally immature patients may be treated nonoperatively, but symptomatic lesions often require surgical intervention. Evidence of instability should be carefully evaluated with preoperative magnetic resonance imaging or computed tomography arthrogram. Careful preoperative planning is necessary to ensure the appropriate surgical approach and implants are selected for surgical management. Multiple techniques have been described, but internal fixation of both "classic" and cartilage-only OCD lesions has been shown to have strong outcomes in managing these difficult cases.
髌股关节剥脱性骨软骨炎(OCD)病变可能难以识别和治疗。骨骼未成熟患者的无症状或稳定病变可采用非手术治疗,但有症状的病变通常需要手术干预。术前应通过磁共振成像或计算机断层扫描关节造影仔细评估不稳定的证据。术前必须进行仔细规划,以确保为手术治疗选择合适的手术入路和植入物。已经描述了多种技术,但“经典”和仅软骨的OCD病变的内固定在处理这些疑难病例方面已显示出良好的效果。