Ichikawa Katsuhiro, Ogawa Hiroyasu, Matsumoto Kazu, Akiyama Haruhiko
Department of Orthopaedic Surgery, Gifu Prefectural General Medical Center, Noishiki 4-6-1, Gifu, Gifu, Japan.
Department of Orthopaedic Surgery, Ogaki Tokushukai Hospital, Hayashi-machi 6-85-1, Ogaki, Gifu, Japan.
Case Rep Orthop. 2021 Jul 8;2021:9958012. doi: 10.1155/2021/9958012. eCollection 2021.
Purely chondral injuries of the knee are relatively rare, and no consensus exists on the appropriate treatment in such cases. We describe two adolescent patients with chondral injury of the knee who were successfully treated by osteochondral peg fixation. . In case 1, a 14-year-old boy presented with complaints of right knee pain after landing on his leg while playing basketball. Radiography and computerized tomography revealed no abnormalities. However, magnetic resonance imaging revealed a chondral defect in his lateral femoral condyle and a loose chondral fragment measuring 6.5 cm. In case 2, a 12-year-old boy presented with complaints of left knee pain after a rotational injury while playing baseball. Similar to case 1, magnetic resonance imaging revealed a chondral defect in his lateral femoral condyle and a loose chondral fragment measuring 3.0 cm. . The two patients were treated by surgical fixation using osteochondral pegs, which were harvested from the femoral condyle. After a year, postoperative computerized tomography and magnetic resonance imaging showed union of the chondral fragment with the osteochondral pegs and surrounding tissue. In both cases, the Lysholm score was 100 points at the final follow-up more than 2 years after surgery.
The findings reported herein suggest that osteochondral peg fixation is a feasible treatment option for chondral injury of the knee, with satisfactory outcomes.
膝关节单纯软骨损伤相对少见，对于此类病例的恰当治疗尚无共识。我们描述了两名青少年膝关节软骨损伤患者，他们通过骨软骨栓固定术获得成功治疗。在病例1中，一名14岁男孩在打篮球时腿部落地后出现右膝疼痛。X线摄影和计算机断层扫描未发现异常。然而，磁共振成像显示其外侧股骨髁有软骨缺损以及一块6.5厘米的游离软骨碎片。在病例2中，一名12岁男孩在打棒球时发生旋转损伤后出现左膝疼痛。与病例1相似，磁共振成像显示其外侧股骨髁有软骨缺损以及一块3.0厘米的游离软骨碎片。这两名患者均采用取自股骨髁的骨软骨栓进行手术固定治疗。一年后，术后计算机断层扫描和磁共振成像显示软骨碎片与骨软骨栓及周围组织愈合。在这两个病例中，术后两年多的最终随访时，Lysholm评分均为100分。
本文报道的结果表明，骨软骨栓固定术是治疗膝关节软骨损伤的一种可行治疗选择，效果满意。
