School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
College of Osteopathic Medicine, University of New England College of Osteopathic Medicine, Biddeford, Maine, USA
BMJ Case Rep. 2021 Jan 27;14(1):e239849. doi: 10.1136/bcr-2020-239849.
Osteochondritis dissecans (OCD) lesions are injuries that occur more commonly in the skeletally immature population. In most cases, the aetiology is not well understood, but fortunately, many OCD lesions may heal on their own over time, particularly in skeletally immature patients with open physes. Conversely, if the lesion is considered unstable, surgical intervention may be required. This case demonstrates an especially rare presentation of bilateral OCD lesions within the lateral femoral trochlear facet. The lesions became symptomatic approximately 1 year apart without a specific injury. Non-operative treatment was not recommended in either case due to the size and instability of each lesion. The surgical treatment used an augmented microfracture technique. At 12 and 23 months after surgery, both knees remain asymptomatic and the patient has returned to their desired activities.
剥脱性骨软骨炎（OCD）病变更常见于骨骼未成熟的人群。在大多数情况下，其病因尚不清楚，但幸运的是，许多 OCD 病变随着时间的推移可能会自行愈合，尤其是在骺板未闭的骨骼未成熟患者中。相反，如果病变被认为不稳定，则可能需要手术干预。本病例展示了一个特别罕见的外侧股骨滑车关节面双侧 OCD 病变表现。病变大约相隔 1 年出现症状，且没有特定的损伤。由于每个病变的大小和不稳定性，均不建议进行非手术治疗。手术治疗采用了增强型微骨折技术。术后 12 个月和 23 个月时，双膝均无症状，患者已恢复到期望的活动水平。
