Department of Orthopaedic Surgery, Shimada Hospital, Habikino.
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka, Japan.
J Pediatr Orthop. 2022 Jul 1;42(6):e649-e655. doi: 10.1097/BPO.0000000000002150. Epub 2022 Mar 29.
This study aimed to compare the healing outcomes of conservative treatment for osteochondritis dissecans (OCD) of the lateral femoral condyle with normal lateral meniscus and incomplete discoid lateral meniscus (DLM).
Forty-four knees in 37 juvenile patients (mean age 9.9 y) with stable OCD and whose lateral meniscus shape was normal or incomplete DLM were enrolled. All patients underwent conservative treatment with physical activities prohibited. For each lateral meniscus group, patient demographics including pretreatment Tegner activity scale, OCD stage, and Lysholm score, radiographic healing status; complete or incomplete healing at 3 months, 6 months, and 1 year, time to complete healing and post-treatment clinical scores were evaluated.
There were 21 (47.8%) and 23 (52.3%) knees with normal menisci and incomplete DLM, respectively. At 3 months, 6 months, and 1 year after conservative treatment, healed OCD status was noted in 3 (14.3%), 12 (57.1%), and 19 (90.5%) knees of the normal type and in 3 (13.0%), 12 (52.2%), and 20 (86.9%) knees of the incomplete DLM type, respectively (P>0.05). The mean time to healing in each group was 198 and 181 days, respectively. No significant differences in terms of OCD healing rate at each time, time to healing, and post-treatment clinical scores were found between the groups.
No significant differences in the OCD healing rate or time to healing were found between the normal and incomplete DLM type. Therefore, treatment strategy for OCD with stable and asymptomatic incomplete DLM should be the same as that for those occurring with a normal meniscus.
本研究旨在比较外侧股骨髁骨软骨炎(OCD)伴正常外侧半月板和不完整盘状外侧半月板(DLM)的保守治疗的愈合结果。
纳入了 37 名青少年患者(平均年龄 9.9 岁)的 44 个膝关节,这些患者均患有稳定的 OCD,且外侧半月板形态正常或为不完整 DLM。所有患者均接受了禁止体育活动的保守治疗。对于每个外侧半月板组,评估了患者的人口统计学资料,包括治疗前的 Tegner 活动量表、OCD 分期和 Lysholm 评分、影像学愈合状态;3 个月、6 个月和 1 年时的完全或不完全愈合、完全愈合时间以及治疗后临床评分。
正常半月板组和不完整 DLM 组分别有 21 个(47.8%)和 23 个(52.3%)膝关节。在保守治疗后 3 个月、6 个月和 1 年时,正常型中有 3 个(14.3%)、12 个(57.1%)和 19 个(90.5%)膝关节的 OCD 状态得到了愈合,而不完整 DLM 型中有 3 个(13.0%)、12 个(52.2%)和 20 个(86.9%)膝关节的 OCD 状态得到了愈合(P>0.05)。每组的平均愈合时间分别为 198 天和 181 天。两组在 OCD 愈合率、愈合时间和治疗后临床评分方面均无显著差异。
正常型和不完整 DLM 型之间的 OCD 愈合率或愈合时间无显著差异。因此,对于稳定无症状的不完整 DLM 伴发的 OCD,其治疗策略应与伴发正常半月板的 OCD 相同。