Sánchez Mikel, Delgado Diego, Garate Ane, Sánchez Pello, Padilla Sabino, Azofra Juan
Arthroscopic Surgery Unit, Hospital Vithas San José, C/ Beato Tomás de Zumarraga 10, 01008, Vitoria-Gasteiz, Spain.
Advanced Biological Therapy Unit, Arthroscopic Surgery Unit, Hospital Vithas San Jose, Vitoria-Gasteiz, Spain.
J Med Case Rep. 2019 Apr 24;13(1):105. doi: 10.1186/s13256-019-2027-6.
Osteochondritis dissecans of the knee is a prevalent pathology in young, active people that is brought about by either traumatic, developmental, or iatrogenic etiologies.
A 40-year-old Caucasian man reporting pain, swelling, and functional reduction was evaluated and diagnosed with internal condyle osteochondritis dissecans of the knee. Harnessing the trophic, chondroprotective, anti-inflammatory, and immunomodulatory properties of platelet-rich plasma, we carried out a knee open-sky surgical technique in which we combined autologous therapy with osteochondral allograft to treat the focal, large, and deep traumatic-iatrogenic osteochondritis dissecans of the knee. The axial computed tomographic scan taken 1 year after surgery revealed an area of abnormal signal intensity that was reduced on a computed tomographic scan 2 years later. The computed tomographic scan obtained 2 years later and the magnetic resonance imaging scan 3 years later also showed a clear reattachment and incorporation of the graft. Seven years after the surgery, the patient resumed his daily routine without any recurrent symptoms.
Platelet-rich plasma application in osteochondral allograft implantation open surgery could enhance the healing process of medial condyle osteochondritis dissecans of the knee.
膝关节剥脱性骨软骨炎在年轻、活跃人群中是一种常见的病理状况，由创伤性、发育性或医源性病因引起。
一名40岁的白人男性，因疼痛、肿胀和功能减退前来就诊，经评估被诊断为膝关节内侧髁剥脱性骨软骨炎。利用富血小板血浆的营养、软骨保护、抗炎和免疫调节特性，我们实施了一种膝关节开放式手术技术，将自体治疗与同种异体骨软骨移植相结合，以治疗膝关节局灶性、大型和深部创伤性医源性剥脱性骨软骨炎。术后1年的轴向计算机断层扫描显示有异常信号强度区域，2年后的计算机断层扫描显示该区域有所减小。2年后的计算机断层扫描和3年后的磁共振成像扫描也显示移植骨明显重新附着并融合。手术后7年，患者恢复了日常活动，没有任何复发症状。
在同种异体骨软骨移植植入开放手术中应用富血小板血浆可促进膝关节内侧髁剥脱性骨软骨炎的愈合过程。
