Edwards D H, Bentley G
J Bone Joint Surg Br. 1977 Feb;59(1):58-63. doi: 10.1302/0301-620X.59B1.845229.
Six cases of osteochondritis dissecans patellae have been studied in five patients in an attempt to clarify the aetiology and prognosis. Assessment of the results of treatment was performed using a standard protocol. The thirty-four previous case reports in the literature are reviewed. In four of the five patients symptoms began after flexing the knee under load and three showed patellar subluxation on tangential radiographs. Thus, repetitive shearing stress on the patellar surface is thought to be an important aetiological factor. The indication for operation is a loose osteochondral fragment either wholly or partly detached from the articular surface of the patella. Vertical excision of the affected area of articular cartilage with drilling of the underlying bone gave two "good" and two "excellent" results. Healing of the drilled area and maintenance of the cartilage space was seen in radiographs of all four cases so treated. This simple method of treatment, which probably causes filling of the defect in the surface by fibrocartilage, is recommended.
为了阐明病因和预后，对5名患者的6例髌骨剥脱性骨软骨炎进行了研究。采用标准方案对治疗结果进行评估。回顾了文献中之前的34例病例报告。5名患者中有4名在负重屈膝后出现症状，3名在切线位X线片上显示髌骨半脱位。因此，髌骨关节面反复的剪切应力被认为是一个重要的病因因素。手术指征是骨软骨碎片完全或部分从髌骨关节面脱离。对关节软骨受累区域进行垂直切除并对下方骨质进行钻孔，获得了2个“良好”和2个“优秀”的结果。所有接受该治疗的4例病例的X线片均显示钻孔区域愈合且软骨间隙保持良好。推荐这种简单的治疗方法，其可能通过纤维软骨填充表面缺损。
