tailieunhanh - Chondral Disease of the Knee - part 2

Tại chuyến thăm của bệnh nhân sau 6 tháng, cô đã không có triệu chứng và đã trở lại cho tất cả các hoạt động. Chụp X quang cho thấy một osteochondritis chữa lành các dissecans tổn thương condyle đùi trung gian (Hình ). | 8 Case 3 Figure . Anteroposterior A and lateral B radiographs obtained 8 weeks postoperatively demonstrate excellent healing of the fragment with no evidence of displacement. Figure . Eight-week arthroscopic view immediately following screw removal demonstrates clinical evidence of union of the osteochondral fragment. This is trial version Case 3 9 Figure Six-month postoperative anteroposterior A and lateral B radiographs demonstrate integration of the fragment with no evidence of further fragmentation. FOLLOW-UP At the patient s 6-month follow-up visit she had no symptoms and had returned to all activities. Radiographs demonstrate a healed osteochondritis dissecans lesion of the medial femoral condyle Figure . DECISION-MAKING FACTORS 1. Young patient with symptomatic lesion of osteochondritis dissecans. 2. Persistent symptoms despite initial treatment with nonoperative protocol. 3. In situ but unstable lesion without significant fragmentation and clinically viable osteochondral fragment large enough to be repaired with screws. 4. Despite need for hardware removal compression fixation used to maximize chances for healing. This is trial version PATHOLOGY Unstable in situ osteochondritis dissecans of the medial femoral condyle TREATMENT Arthroscopic fixation of osteochondral fragment followed by loose body removal SUBMITTED BY Brian J. Cole MD MBA Rush Cartilage Restoration Center Rush University Medical Center Chicago Illinois USA CHIEF COMPLAINT AND HISTORY OF PRESENT ILLNESS The patient is an active 35-year-old woman who had no previous history of knee problems until the insidious onset of medial-sided right knee pain swelling and weight-bearing discomfort that began 6 months before presentation. She denied any trauma and was actively participating in snow skiing running and aerobics before the onset of these symptoms. She does not ever recall knee symptoms as a child or adolescent. She was referred for treatment

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