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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Comparison of Weightbearing and Nonweightbearing Juvenile Osteochondritis Dissecans Lesions of the Lateral Femoral Condyle
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Comparison of Weightbearing and Nonweightbearing Juvenile Osteochondritis Dissecans Lesions of the Lateral Femoral Condyle

机译：横向股骨髁突厥的举重和非重量骨龄核心骨膜症的比较

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Background: Repetitive microtrauma may contribute to osteochondritis dissecans (OCD) lesions of the femoral condyle. The effect of differential loading between OCD weightbearing (WB) zones has not been studied. Purpose: To determine whether clinical and radiographic variables differ by WB zone in lateral femoral condyle OCD lesions. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively reviewed a consecutive series of patients aged & 18 years with lateral femoral condyle OCD lesions presenting at a single institution between 2004 and 2018. Patients with OCD lesions outside of the lateral femoral condyle were excluded. Lesions were localized on radiographs using the Cahill and Berg classification, referencing the Blumensaat line and an extension of the posterior femoral cortex. Progeny bone characteristics evaluated at baseline and 24-month follow-up included ossification, distinct borders from parent bone, and displacement. Baseline lesion dimensions were measured on magnetic resonance imaging (MRI) scans. We evaluated posttreatment pain level, return-to-activity rate, and patient-reported outcome measures (PROMs) including the Pediatric International Knee Documentation Committee score, Knee injury and Osteoarthritis Outcome Score, and Pediatric Functional Activity Brief Scale. Results: A total of 62 lateral femoral condyle OCD lesions (mean follow-up, 24.1 months) presented within the study period: 26 WB lesions and 36 nonweightbearing (NWB) lesions. At presentation, no differences between the lesion types were observed in symptom chronicity or symptomatology. NWB lesions were deeper on MRI scans (sagittal depth, 7.11 vs 5.96 mm; P = .046; coronal depth ratio, 0.05 vs 0.01 mm; P = .003), were more likely to develop progeny bone (69.4% vs 44%; P = .047), and demonstrated higher radiographic healing rates (52.8% vs 24%; P = .025) compared with WB lesions. PROMs at follow-up were available for 25 of 62 patients (40.3%), with no statistically significant differences between cohorts at any time. Return to full activity was observed in 72% of WB and 82.1% of NWB lesions ( P = .378). Conclusion: Lateral femoral condyle OCD lesions of the knee in WB and NWB zones presented similarly at initial evaluation; however, NWB lesions demonstrated higher rates of progeny bone formation and radiographic healing at mean 2-year follow-up.
机译：背景：重复的MicroTrauma可能有助于骨科髁骨髓炎（OCD）病变的股髁的病变。尚未研究OCD加重（WB）区之间的差异载荷的影响。目的：确定临床和射线照相变量是否在侧向股骨髁OCD病变中的WB区域不同。研究设计：队列研究;证据水平，3.方法：我们回顾性地审查了连续的患者患者＆amp; ;在2004年至2018年期间的单一机构介绍了18岁，2004年至2018年间的一个机构。患有外侧股骨髁外的OCD病变的患者被排除在外。使用Cahill和Berg分类，参考Blumensaat线和后部股骨皮质的延伸，在射线照相上定位病变。在基线和24个月后续进行的后代骨骼特征包括骨化，来自父母骨骼的截然不同的边界，以及位移。在磁共振成像（MRI）扫描上测量基线病变尺寸。我们评估了痛苦疼痛水平，恢复活动率和患者报告的结果措施（PROMS），包括儿科国际膝关节文件评分，膝关节损伤和骨关节炎结果评分，以及儿科功能活动简短规模。结果：在研究期内，共有62例侧向股骨髁OCD病变（平均随访，24.1个月）：26个WB病变和36例非免载（NWB）病变。在介绍中，在症状慢性或症状中没有观察到病变类型之间的差异。 NWB病变对MRI扫描（矢状深度，7.11 Vs 5.96mm; P = .046;冠状深度比，0.05 Vs 0.01mm; p = .003），更有可能开发后代骨（69.4％与44％;与WB病变相比，P = .047），并证明了更高的射线照相愈合率（52.8％vs 24％; p = .025）。随访中的舞会可用于62名患者中的25名（40.3％），任何时候队列之间没有统计学上显着的差异。在72％的WB和82.1％的NWB病变中恢复到全部活动（P = .378）。结论：在初始评估时，WB和NWB区膝关节膝关节的侧向股骨髁突病变;然而，NWB病变表现出更高的后代骨形成和射线照相愈合，平均2年后续随访。

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