关节镜下采用结构性胫骨松质骨自体骨移植固定青少年膝关节不稳定型剥脱性骨软骨炎
简介
本文介绍一种关节镜技术：对青少年不稳定膝关节剥脱性骨软骨炎，采用条状结构性胫骨松质骨自体骨移植，复位并固定原生骨软骨块，以恢复关节面解剖适合性并填充软骨下骨缺损。文章按步骤描述手术操作，未报告临床结果；对合并明显软骨下骨丢失的不稳定病变，该技术可作为保留自体骨软骨块的关节镜治疗选择。
英文摘要
The treatment of knee osteochondritis dissecans in young patients remains challenging. Unstable or displaced lesions and those unresponsive to conservative management require surgical treatment. Because the articular surface morphology is complex and patient-specific, preservation and fixation of the native osteochondritis dissecans fragment are ideal for maintaining anatomic congruity. Structural bone grafting is desirable in cases of unstable lesions with substantial subchondral bone loss because it provides effective defect filling, greater mechanical support for large defects, and resistance to postoperative lesion collapse. Arthroscopy offers several advantages over traditional open approaches through an arthrotomy, including reduced surgical invasiveness, improved visualization of intra-articular pathology, and accelerated postoperative recovery. However, studies describing the optimal arthroscopic techniques are limited. Therefore, this article aims to describe a step-by-step arthroscopic technique of structural strip-shaped tibial cancellous bone grafting for unstable adolescent knee osteochondritis dissecans lesions.