Randsborg Per-Henrik, Kjennvold Stian, Røtterud Jan Harald
Department of Orthopedic Surgery, Akershus University Hospital, Lørenskog, Norway.
Arthrosc Tech. 2019 Sep 19;8(10):e1115-e1120. doi: 10.1016/j.eats.2019.05.031. eCollection 2019 Oct.
Osteochondritis dissecans (OCD) of the knee affects children and adolescents. The condition is characterized by sterile osteonecrosis of the subchondral bone. The cause is unknown. OCD is divided into juvenile or adult type, depending on whether the physis is open or closed at the time of diagnosis. Stable juvenile OCD lesions have substantial healing potential and are treated conservatively, with a healing potential of up to 75%. However, in unstable lesions and in all symptomatic adult OCD lesions, surgical treatment is indicated. The purpose of this article was to present our method of arthroscopic fixation of an unstable OCD in the knee, using a motorized pick to stimulate the bed of the lesion, and firm fixation with headless screws. The advantage of this method is the controlled and meticulous debridement and stimulation of the sclerotic necrosis behind the OCD fragment and the firm compression achieved with the screws, enabling an intensive and early rehabilitation.
膝关节剥脱性骨软骨炎（OCD）影响儿童和青少年。该病的特征是软骨下骨无菌性坏死。病因不明。根据诊断时骨骺是否开放，OCD分为青少年型或成人型。稳定的青少年OCD病变具有很大的愈合潜力，采用保守治疗，愈合潜力高达75%。然而，对于不稳定病变和所有有症状的成人OCD病变，均需手术治疗。本文的目的是介绍我们采用电动骨锥刺激病变床，并使用无头螺钉进行牢固固定的关节镜下固定膝关节不稳定OCD的方法。该方法的优点是对OCD碎片后方的硬化性坏死进行可控且细致的清创和刺激，以及通过螺钉实现牢固加压，从而能够进行强化和早期康复。
