Fonseca Fernando
Serviço de Ortopedia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Rev Bras Ortop. 2018 Sep 19;53(6):797-801. doi: 10.1016/j.rboe.2018.09.004. eCollection 2018 Nov-Dec.
Joint preservation surgery is accepted in cases of secondary osteonecrosis of the knee without joint collapse. However, there is no consensus on the best treatment: debridement and drilling, or use of auto- or allograft. The author describes a clinical case with 15 years of evolution where allogeneic osteochondral graft was used in the treatment of osteonecrosis of the lateral femoral condyle in a young woman with systemic lupus. In spite of having other options and of the results reported in the literature, the functional evaluation 15 years later presented excellent results, with total autonomy of the patient for daily life and work tasks, indicating that the option for osteochondral allograft may be a good solution.
对于无关节塌陷的膝关节继发性骨坏死病例,关节保留手术是可以接受的。然而,对于最佳治疗方法尚无共识:清创钻孔术,还是使用自体或异体移植物。作者描述了一例病程长达15年的临床病例,该病例为一名患有系统性红斑狼疮的年轻女性,采用同种异体骨软骨移植治疗外侧股骨髁骨坏死。尽管有其他选择以及文献报道的结果,但15年后的功能评估显示出优异的结果,患者在日常生活和工作任务中完全自主,这表明同种异体骨软骨移植可能是一个很好的解决方案。