Aglietti P, Buzzi R, Bassi P B, Fioriti M
First Orthopaedic Clinic, University of Florence, Italy.
Arthroscopy. 1994 Jun;10(3):286-91. doi: 10.1016/s0749-8063(05)80113-6.
Fourteen children affected by juvenile osteochondritis dissecans of the medial femoral condyle (16 knees) were treated by arthroscopic drilling of the lesion. The average age at operation was 12.8 years, and all the knees had open physes. Conservative treatment including restriction of activities had been unsuccessfully attempted in all cases for a period of > 1 year on average. At surgery each lesion was shown to have intact articular cartilage. All the lesions progressed to healing, and the patients were asymptomatic at an average of 56 months after the operation. Radiographic examination showed reconstitution of a normal or minimally flattened profile of the medial condyle. Arthroscopic drilling of the lesion in knees with juvenile osteochondritis dissecans and intact articular cartilage was effective to promote healing. The low morbidity and easy rehabilitation justify the procedure for these young patients when conservative measures fail.
14名患有股骨内侧髁青少年剥脱性骨软骨炎的儿童（16个膝关节）接受了关节镜下病灶钻孔治疗。手术时的平均年龄为12.8岁，所有膝关节的骨骺均未闭合。所有病例均平均经过超过1年的包括限制活动在内的保守治疗，但均未成功。手术时发现每个病灶的关节软骨均完整。所有病灶均愈合，患者术后平均56个月时无症状。影像学检查显示内侧髁恢复正常或仅有轻微变平。对于患有青少年剥脱性骨软骨炎且关节软骨完整的膝关节，关节镜下病灶钻孔可有效促进愈合。当保守治疗失败时，该手术的低发病率和易于康复的特点证明其适用于这些年轻患者。
