Koshino T, Okamoto R, Takamura K, Tsuchiya K
Orthop Clin North Am. 1979 Jul;10(3):609-18.
Eight knees with spontaneous osteonecrosis were investigated through arthroscopy, and in seven the intra-articular findings were rechecked at arthrotomy performed one to two weeks later. Anbormalities in the articular cartilage were observed in detail under arthroscopy that could not be seen in roentgenograms. In the early stage of osteonecrosis, flattening and fissures in the articular surfaces, with and without formation of a cartilage flap, were useful findings in choosing intra-articular surgical procedures. In the late stage, free bodies such as cartilage plates in the joint and regeneration with fibro-cartilaginous tissue over the necrotic lesion were also important in selecting surgical treatment. In addition to roentgenographic classification of developmental stages in osteonecrosis, arthroscopy is necessary in differentiating osteoarthroses, in observing the articular surface of the femoral condyles, and in determining the stage of disease when roentgenography provided insufficient information to justify intra-articular procedures such as drilling and bone grafting.
对8例自发性骨坏死膝关节进行了关节镜检查，并对其中7例在1至2周后进行关节切开术时再次检查关节内情况。在关节镜下详细观察到关节软骨的异常，而这些异常在X线片上是看不到的。在骨坏死早期，关节面的扁平及裂隙，无论有无软骨瓣形成，对于选择关节内手术方式都是有用的发现。在晚期，关节内的游离体如软骨板以及坏死病变上纤维软骨组织的再生，对于选择手术治疗也很重要。除了对骨坏死发育阶段进行X线分类外，关节镜检查对于鉴别骨关节炎、观察股骨髁关节面以及在X线片提供的信息不足以证明进行诸如钻孔和植骨等关节内手术的合理性时确定疾病分期都是必要的。
