Hopkinson W J, Mitchell W A, Curl W W
Am J Sports Med. 1985 Sep-Oct;13(5):309-12. doi: 10.1177/036354658501300504.
Knee pain in the athlete can pose difficulty in diagnosis. At the United States Military Academy at West Point we have had occasion to see a group of patients presenting with meniscal symptoms of locking, catching, giving way, and joint line tenderness who, on arthroscopic examination, have chondral fractures of the medial or lateral femoral condyle. These individuals have undergone arthroscopy and debridement of the chondral defect. Both retrospectively and prospectively we have been unable to find any defects on radiographs and there appears to be purely cartilaginous involvement. These individuals appear to have a relatively poor prognosis for recovery after arthroscopy. Treatment has been a standard course of range of motion exercises, strengthening, and antiinflammatory medications. However, the mean rehabilitation time has been almost triple the time associated with a routine meniscal injury. We feel that it is important to discuss the chondral fracture so that the orthopaedic surgeon can be aware of this possibility in the differential diagnosis of knee pain in the athlete.
运动员的膝关节疼痛可能在诊断上存在困难。在美国西点军校，我们曾有机会见到一群表现出半月板症状（如交锁、卡顿、打软腿和关节线压痛）的患者，经关节镜检查发现他们存在股骨内侧髁或外侧髁的软骨骨折。这些患者接受了关节镜检查及软骨缺损清创术。回顾性和前瞻性研究中，我们在X线片上均未发现任何缺损，似乎仅有软骨受累。这些患者关节镜检查后的恢复预后相对较差。治疗采用了标准的活动度练习、强化训练和抗炎药物疗程。然而，平均康复时间几乎是常规半月板损伤康复时间的三倍。我们认为讨论软骨骨折很重要，这样骨科医生在运动员膝关节疼痛的鉴别诊断中就能意识到这种可能性。
