Cotter Eric J, Waterman Brian R, Kelly Mick P, Wang Kevin C, Frank Rachel M, Cole Brian J
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
Arthrosc Tech. 2017 Aug 21;6(4):e1393-e1398. doi: 10.1016/j.eats.2017.05.025. eCollection 2017 Aug.
Symptomatic patellofemoral chondral lesions are a challenging clinical entity, as these defects may result from persistent lateral patellar maltracking or repetitive microtrauma. Anteromedializing tibial tubercle osteotomy has been shown to be an effective strategy for primary and adjunctive treatment of focal or diffuse patellofemoral disease to improve the biomechanical loading environment. Similarly, osteochondral allograft transplantation has proven efficacy in physiologically young, high-demand patients with condylar or patellofemoral lesions, particularly without early arthritic progression. The authors present the surgical management of a young athlete with symptomatic tricompartmental focal chondral defects with fresh osteochondral allograft transplantation and anteromedializing tibial tubercle osteotomy.
有症状的髌股关节软骨损伤是一个具有挑战性的临床实体,因为这些缺损可能由持续性髌骨外侧轨迹不良或重复性微创伤引起。胫骨结节内移截骨术已被证明是治疗局限性或弥漫性髌股关节疾病的一种有效策略,可改善生物力学负荷环境。同样,异体骨软骨移植在生理上年轻、需求高的髁或髌股关节损伤患者中已证明有效,尤其是在没有早期关节炎进展的情况下。作者介绍了一名年轻运动员的手术治疗,该运动员患有有症状的三关节局限性软骨缺损,采用新鲜异体骨软骨移植和胫骨结节内移截骨术。