tailieunhanh - Chondral Disease of the Knee - part 4

Bệnh nhân là một phụ nữ 44 tuổi với một khiếu nại chính của đau đầu gối và đau đớn trước với trọng lượng mang theo các khía cạnh trung gian của đầu gối phải của cô. Ngoài ra, cô có những triệu chứng cơ tái phát, | 13 PATHOLOGY Focal chondral defect of the medial femoral condyle and patella TREATMENT Osteochondral autograft of the medial femoral condyle and microfracture of the patella 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 a 44-year-old woman with a chief complaint of anterior knee pain and pain with weight bearing along the medial aspect of her right knee. Additionally she has recurrent mechanical symptoms swelling difficulty doing her work and inability to participate in her hobby as a sport barrel jumper. Two years prior she had an arthroscopic chondral debridement and was diagnosed with a full-thickness chondral defect of her medial femoral condyle documented to be the size of a dime and a similarly sized nearly full thickness lesion of her patella. She did not respond favorably to this arthroscopy and remained symptomatic. Before being indicated for repeat surgical intervention she demonstrated a failure to respond to a rigorous patellofemoral rehabilitation program. PHYSICAL EXAMINATION Height 5 ft 4 in. weight 1301b. The patient walks with a nonantalgic gait and her alignment is symmetric in slight physiologic valgus. She has a small effusion. Her range of motion is 0 to 130 degrees. She is tender to palpation over the medial femoral condyle in flexion. She graft transplant Figure . This is trial version has palpable patellofemoral crepitus at 45 degrees of knee flexion with no patellar apprehension. Meniscal findings are absent and her ligament examination is within normal limits. She has no quadriceps atrophy and has a Q angle of less than 8 degrees. RADIOGRAPHIC EVALUATION Plain radiographs were within normal limits. Magnetic resonance studies demonstrated both chondral lesions with subchondral edema behind the medial femoral condyle lesion. SURGICAL INTERVENTION Because of her persistent symptoms and failure to .

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