Jürgensen I, Bachmann G, Siaplaouras J, Cassens J
Orthopädische Klinik und Poliklinik, Justus-Liebig-Universität Giessen.
Unfallchirurg. 1996 Oct;99(10):758-63. doi: 10.1007/s001130050052.
A prospective study was performed on 72 patients with osteochondritis dissecans (OD) of the knee and ankle to compare plane radiography, MRI and arthroscopy before therapeutic procedures. Special interest was placed on the assessment of fragment stability with radiological methods for staging related therapy. OD was localized in 46 cases on the femoral condyle and in 26 cases on the talus. Radiological methods were performed simultaneously and shortly before definite arthroscopical therapy. Using conventional radiography, OD of the condyles was staged according to the classification of Rodegerdts and Gleissner and OD of the talus suggested by Berndt and Harty. MRI staging was performed by morphology of the interface of the OD. Arthroscopical staging based on the classification of Guhl. There was an excellent correlation between the stages in MRI and arthroscopy, showing correct prediction of stable and unstable fragments in 92%. In contrast, fragment stability could not be efficiently assessed by conventional radiology because fragments could be stably fixed in cases of bony separation. MRI is indicated before performance of staging-related therapy of OD to select patients with stable fragments for conservative therapy and those with unstable OD for surgical therapy.
对72例膝关节和踝关节剥脱性骨软骨炎（OD）患者进行了一项前瞻性研究，以比较治疗前的X线平片、MRI和关节镜检查。特别关注用放射学方法评估碎片稳定性以进行分期相关治疗。OD位于股骨髁46例，距骨26例。放射学检查在明确的关节镜治疗前同时进行。使用传统X线平片，根据Rodegerdts和Gleissner的分类对髁部OD进行分期，根据Berndt和Harty的建议对距骨OD进行分期。MRI分期根据OD界面形态进行。关节镜分期基于Guhl的分类。MRI和关节镜检查的分期之间存在极好的相关性，92%能正确预测稳定和不稳定碎片。相比之下，传统放射学无法有效评估碎片稳定性，因为在骨质分离的情况下碎片可能已稳定固定。在进行OD分期相关治疗前，建议进行MRI检查，以选择碎片稳定的患者进行保守治疗，选择OD不稳定的患者进行手术治疗。
