Đang chuẩn bị nút TẢI XUỐNG, xin hãy chờ
Tải xuống
Tổn thương sụn khớp ở đầu gối là phổ biến, may mắn thay, khiếm khuyết sụn khớp đầy đủ độ dày chỉ chiếm một phần nhỏ của nhóm này. Các tổn thương này có thể được tình cờ gặp phải trong quá trình phẫu thuật dây chằng hoặc meniscal, đã im lặng hoặc không có triệu chứng trong một thời gian chưa có thời gian. | Surgical Alternatives for Treatment of Articular Cartilage Lesions Jon E. Browne MD and Thomas P. Branch MD Abstract Articular cartilage injuries in the knee are common fortunately full-thickness articular cartilage defects constitute only a small portion of this group. These lesions may be incidentally encountered during ligament or meniscal surgery having been silent or asymptomatic for an unknown period of time. However when they are large and symptomatic the surgeon may choose from a wide array of techniques available for treatment. The relatively small number of natural history studies regarding full-thickness articular surface lesions complicates the decision-making process. Accurate evaluation and classification of the anatomic defect aids in the development of a clinical algorithm for treatment. Surgical techniques are either reparative or restorative in nature. Reparative techniques fall short of complete reestablishment of the articular cartilage however the resultant repairs may remain quite functional for varying periods of time. Restorative techniques attempt to reestablish the native articular surface. To date no peer-reviewed prospective randomized controlled studies of operative versus nonoperative treatment for full-thickness articular cartilage lesions have been published. Even though the long-term results of surgical treatment for full-thickness articular surface lesions remain unknown the early results are encouraging. J Am Acad Orthop Surg 2000 8 180-189 without treatment 14 years after diagnosis. Although this might imply that most chondral lesions are asymptomatic the majority of their patients had abnormal radiographic findings suggesting that some asymptomatic lesions do go on to permanently damage the knee. Maletius and Messner3 also reported on a 12- to 15-year follow-up of 42 matched patients with chondral damage who were treated with or without partial meniscectomy. Radiographic follow-up revealed more significant changes P 0.03 in .
