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生长期间膝关节的非创伤性骨软骨损伤:膝关节青少年剥脱性骨软骨炎(JOCD)

[Non-traumatic osteochondral lesions of the knee joint during growth : Juvenile osteochondritis dissecans (JOCD) of the knee].

作者信息

Tsaknakis Konstantinos, Afifi Faik K, Lorenz Heiko M, Hell Anna K

机构信息

Kinderorthopädie, Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland.

出版信息

Orthopadie (Heidelb). 2024 Sep;53(9):651-658. doi: 10.1007/s00132-024-04552-0. Epub 2024 Aug 28.

Abstract

BACKGROUND

Juvenile osteochondritis dissecans of the knee joint is the most common osteochondral lesion during growth, usually occurring between the 10th and 14th year of age.

PATHOGENESIS

Repetitive microtraumata lead to a subchondral osseus lesion, which is commonly located at the medial aspect of the femoral condyle. Sport activities are considered to be the main cause, although genetic and hereditary factors as well as vitamin D deficiency also play a role. Current classification systems distinguish between stable and unstable osteochondral lesions, which is decisive for further treatment.

TREATMENT

Stable lesions may heal through conservative treatment by avoiding weight bearing and sport. Unstable lesions, on the other hand, can lead to a complete defect of the joint surface with the formation of a free joint body. In such cases, various surgical techniques aim at reconstructing the surface of the joint, in order to reduce the risk of secondary arthritis.

摘要

背景

青少年膝关节剥脱性骨软骨炎是生长过程中最常见的骨软骨病变,通常发生在10至14岁之间。

发病机制

反复的微创伤导致软骨下骨病变,常见于股骨髁内侧。体育活动被认为是主要原因,尽管遗传和遗传因素以及维生素D缺乏也起一定作用。目前的分类系统区分稳定和不稳定的骨软骨病变,这对进一步治疗具有决定性意义。

治疗

稳定的病变可通过避免负重和运动的保守治疗而愈合。另一方面,不稳定的病变可导致关节面完全缺损并形成游离关节体。在这种情况下,各种手术技术旨在重建关节表面,以降低继发性关节炎的风险。

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