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股骨内侧髁剥脱性骨软骨炎:一例报告及自体镶嵌植骨术在关节软骨修复中作用的综述

Osteochondritis Dissecans in the Medial Femoral Condyle: A Case Report and Review of the Role of Autogenous Mosaicplasty in Articular Cartilage Repair.

作者信息

Aljadaan Bader, Alotaibi Fahad, Maghrabi Sarah A, Alanazi Sultan Mohammed F, Alqifari Faisal A

机构信息

Orthopaedic Surgery, Prince Sultan Military Medical City, Riyadh, SAU.

Orthopaedic Surgery, King Saud University Medical City, Riyadh, SAU.

出版信息

Cureus. 2024 Dec 5;16(12):e75167. doi: 10.7759/cureus.75167. eCollection 2024 Dec.

DOI:10.7759/cureus.75167
PMID:39759593
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11699967/
Abstract

Osteochondritis dissecans is a rare condition characterized by the deterioration of a small area of bone and cartilage without infection. Its exact cause is unclear, though factors such as abnormal bone development, joint pressure, repetitive injuries, inadequate blood supply, and genetic links have been observed. In this case, a 27-year-old woman experienced chronic right knee pain following a twisting injury, which led to reduced mobility and mild pain. Examination showed no swelling or tenderness, although X-rays and further imaging revealed irregularities in the medial femoral condyle, a 1.5 cm osteochondral defect, a loose fragment, and mild degenerative changes in the meniscus and partial ligament injuries. Post-surgical management included early gentle movements and a transition to running four months post-operatively. Follow-ups at 10 days and six weeks showed a full range of motion with no pain or complications. Successful graft integration and healing were confirmed without significant osteoarthritic changes, indicating effective joint preservation. This case illustrates the potential of autograft mosaicplasty in treating osteochondritis dissecans, underlining the importance of individualized treatment approaches to address articular cartilage injuries effectively. Long-term results and the factors contributing to the disorder remain areas for further research.

摘要

剥脱性骨软骨炎是一种罕见的病症,其特征是一小片骨和软骨发生退变且无感染。尽管已观察到诸如骨骼发育异常、关节压力、重复性损伤、血液供应不足和遗传关联等因素,但其确切病因尚不清楚。在该病例中,一名27岁女性在扭伤后出现右膝慢性疼痛,导致活动能力下降和轻度疼痛。检查未发现肿胀或压痛,尽管X线检查和进一步的影像学检查显示股骨内侧髁有异常、存在1.5厘米的骨软骨缺损、有一个游离碎片,半月板有轻度退变改变以及部分韧带损伤。术后管理包括早期轻柔活动以及术后四个月过渡到跑步。术后10天和六周的随访显示关节活动范围正常,无疼痛或并发症。确认移植成功融合且愈合良好,无明显骨关节炎改变,表明关节得到了有效保留。该病例说明了自体镶嵌植骨术在治疗剥脱性骨软骨炎方面的潜力,强调了采用个体化治疗方法有效处理关节软骨损伤的重要性。长期结果以及导致该病症的因素仍是有待进一步研究的领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b04/11699967/d3036d0ee4cd/cureus-0016-00000075167-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b04/11699967/5a3ebe63fa8c/cureus-0016-00000075167-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b04/11699967/378f8ce2d752/cureus-0016-00000075167-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b04/11699967/dbc4dea00545/cureus-0016-00000075167-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b04/11699967/d3036d0ee4cd/cureus-0016-00000075167-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b04/11699967/5a3ebe63fa8c/cureus-0016-00000075167-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b04/11699967/378f8ce2d752/cureus-0016-00000075167-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b04/11699967/dbc4dea00545/cureus-0016-00000075167-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b04/11699967/d3036d0ee4cd/cureus-0016-00000075167-i04.jpg

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本文引用的文献

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Life (Basel). 2021 Nov 8;11(11):1205. doi: 10.3390/life11111205.
2
Autogenous Osteochondral Grafting for Treatment of Knee Osteochondritis Dissecans: A Case Series Study.自体骨软骨移植治疗膝关节剥脱性骨软骨炎:病例系列研究
Arch Bone Jt Surg. 2020 May;8(3):426-431. doi: 10.22038/abjs.2019.39026.2038.
3
Osteochondritis dissecans of the knee.膝关节剥脱性骨软骨炎
Joints. 2014 May 8;2(1):29-36. eCollection 2014 Jan-Mar.
4
Bilateral osteochondritis dissecans of the femoral condyles in both knees: a report of two sibling cases.双膝股骨髁双侧剥脱性骨软骨炎:两例同胞病例报告
Knee Surg Relat Res. 2013 Jun;25(2):88-92. doi: 10.5792/ksrr.2013.25.2.88. Epub 2013 May 29.
5
A prospective, randomized clinical study of osteochondral autologous transplantation versus microfracture for the treatment of osteochondritis dissecans in the knee joint in children.一项关于自体骨软骨移植与微骨折术治疗儿童膝关节剥脱性骨软骨炎的前瞻性随机临床研究。
J Pediatr Orthop. 2009 Oct-Nov;29(7):741-8. doi: 10.1097/BPO.0b013e3181b8f6c7.
6
A correlation between the timing of biopsy after autologous chondrocyte implantation and the histological appearance.自体软骨细胞植入术后活检时间与组织学表现之间的相关性。
J Bone Joint Surg Br. 2009 Sep;91(9):1172-7. doi: 10.1302/0301-620X.91B9.22490.
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Autologous osteochondral grafting--technique and long-term results.自体骨软骨移植——技术与长期效果
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