膝剥脱性骨软骨炎关节镜下特征及镜下软骨修整和移植术

Arthroscopic characteristics of osteochondritis dissecans of the knee and restoration of the articular surface or autologous osteochondral mosaicplasty under arthroscopy

目的探讨关节镜诊断和治疗膝关节剥脱性骨软骨炎（OCD）的方法和疗效。方法42例膝股骨负重面软骨剥脱患者,关节镜下行自体骨软骨移植4例,行钻孔术12例,行清理术26例。结果42例患者术后均随访8～48个月,术前Lysholm评分平均为45.2分（36～58分）,术后平均为81.2分（52～99分）,总优良率83.3%。结论膝关节剥脱性骨软骨炎的治疗应根据患者不同年龄,软骨缺损范围,关节镜下选择不同的术式,可取得较满意疗效。

Objective To investigate the methods and the clinical effect of arthroscope on diagnosing and treating osteochndritis dissecan（sOCD）of knee. Methods There were 42 patients with cartilaginous defects on the femoral weight-bearing surface, including 4 adults ranging from 20-41 years in age（mean, 29 years） treated with autogenous osteochondral transplantation under arthroscopy, and the area of local cartilaginous defects was of 2-4 cm^2. Drilling was performed in 12 cases with the age ranging from 16-64 （mean, 46 years）, whose cartilaginous defects was of 2.5-8 cm^2 , while arthroscopic debridement was applied in 26 patients who were from 50-65 years in age（mean, 55 years） and the area of defects was of 4.5-11 cm^2. Results All the cases were followed up for 8 to 48 months （mean,24 months）, the average Lysholm score was 45.2 points （36-58 points） preoperatively, and 81.2 points （52-99 points） postoperatively. The total excellent and good rate was 83.3%. Conclusion A satisfactory result can be achieved in treating OCD of knee with different arthroscopic surgery according to sufferer’s age and the area of cartilaginous defects.