Hoffer Alexander J, Lin Eugenia A, Kalani Maziyar A, Lyons Mark K, Richardson Meghan
Department of Orthopedic Surgery Mayo Clinic, 5881 E. Mayo Blvd., Phoenix, AZ 85054, USA.
Case Rep Orthop. 2024 Jun 6;2024:9998388. doi: 10.1155/2024/9998388. eCollection 2024.
Heterotopic ossification is ectopic lamellar bone formation within soft tissue and can result in significant functional limitations. There are multiple underlying etiologies of HO including musculoskeletal trauma and traumatic brain injury. Intra-articular HO of the knee is rare and is typically located within the cruciate ligaments. We report a case of a 24-year-old female who presented with worsening right knee pain and limited knee extension two and a half years after a motor vehicle crash with multiple lower extremity fractures. Physical examination of the knee revealed anterior pain, limited extension, and a palpable infrapatellar prominence. Imaging showed a retropatellar tendon, intra-articular excrescence of bone proximal to the anterior tibial plateau. Diagnostic arthroscopy with a 70° arthroscope identified HO at the proximal anterior tibial plateau, which was excised with a high-speed burr under direct visualization. At the three-month follow-up, the patient remained asymptomatic and returned to sport. Retropatellar tendon, intra-articular anterior knee HO is a rare but debilitating clinical entity that can be successfully and safely managed with excision under direct visualization using a 70° arthroscope.
异位骨化是指在软组织内形成异位板层骨，可导致严重的功能受限。异位骨化有多种潜在病因，包括肌肉骨骼创伤和创伤性脑损伤。膝关节内的异位骨化较为罕见，通常位于交叉韧带内。我们报告一例24岁女性病例，该患者在机动车事故导致多处下肢骨折两年半后，出现右膝疼痛加重及膝关节伸展受限。膝关节体格检查发现前方疼痛、伸展受限，髌下可触及肿块。影像学检查显示髌后肌腱、胫骨平台前方近端关节内骨质增生。使用70°关节镜进行诊断性关节镜检查发现胫骨平台近端前方存在异位骨化，在直视下用高速磨钻将其切除。在三个月的随访中，患者无症状并恢复运动。髌后肌腱、膝关节前方关节内异位骨化是一种罕见但使人衰弱的临床病症，使用70°关节镜在直视下切除可成功且安全地对其进行治疗。
