tailieunhanh - Chondral Disease of the Knee - part 3

Bệnh nhân này là một người đàn ông 31 tuổi, duy trì, duy nhất cho cách tập của đầu gối trái của mình, sau một sai lầm khoảng 4 tháng trước khi đánh giá. Kể từ khi chấn thương ban đầu của mình, ông đã có tập chiều cho một số hyperextension loại | PATHOLOGY Isolated small grade IV medial femoral condyle chondral lesion TREATMENT Primary osteochondral autograft transplantation 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 This patient is a 31-year-old man who sustained a single giving-way episode of his left knee after a misstep approximately 4 months before evaluation. Since his initial injury he has had several hyperextension-type giving-way episodes. He complains of activity-related swelling and medial knee pain with weight bearing. He is unable to participate in any impact-type activities. SURGICAL INTERVENTION Because of his persistent symptoms he was indicated for a diagnostic arthroscopy and evaluation for possible chondral injury. At the time of arthroscopy he was noted to have a 10 mm by 10 mm grade IV lesion along the weightbearing portion of his medial femoral condyle Figure . It was elected to proceed with primary osteochondral autograft transplantation Figure . Postoperatively the patient PHYSICAL EXAMINATION Height 6ft 2 in. weight 1881b. He ambulates with a nonantalgic gait. He stands in neutral alignment. His left knee has a moderate effusion. His range of motion is 0 to 130 degrees. He is tender to palpation over the medial femoral condyle. Meniscal findings are absent. His ligament examination is within normal limits. RADIOGRAPHIC EVALUATION Figure . Arthroscopic photograph of the 10 Plain radiographs and magnetic resonance mm by 10 mm lesion along the weight-bearing imaging MRI arc wkta normal limits. . poflon ol b s media femoral condyle. This is trial version 23 24 Case 8 Figure . The defect was A sized and B subsequently extracted using a 10-mm coring reamer. C Autograft plug obtained from region of lateral sulcus terminalis is impacted into place. was made partial weight bearing for approximately 4 to 6 weeks and placed on continuous