剥脱性骨软骨炎的研究进展

剥脱性骨软骨炎随着青少年运动的普及,其发病率呈增长趋势,但其发病机制尚未明确。既往研究认为创伤是其潜在病因,但随着越来越多家族性病例的出现,遗传因素也逐渐被人们所重视。关节镜是目前诊断剥脱性骨软骨炎的“金标准”,但对于早期关节面尚完整的病变,MRI的诊断价值大于关节镜。临床通过调整活动、固定器和药物等非手术管理治疗稳定型剥脱性骨软骨炎。对于不稳定型或保守治疗不佳的患者建议早期手术,采取关节清理、钻孔、微骨折术、固定和移植等措施。随着研究的深入,干细胞技术和富集血小板血浆逐渐应用于软骨修复,必定能提高剥脱性骨软骨炎的疗效,但仍需更深入的临床和实验研究,也有待长期有效的随访结果。

Progress on osteochondritis dissecans

Along with the popularity of youth movement, the incidence of osteochondritis dissecans(OCD) showed a trend of increase, but its pathogenesis is not yet clear. Previous studies suggested that trauma is the main potential cause, but with the emergence of vast family cases, hereditary factor is also gradually taken seriously. Arthroscopy is the "gold standard" for diagnosing OCD, but for the patient with early incomplete joint surface lesions, the diagnositic value of MRI is better than the arthroscopy. For the patients with stable form OCD, nonoperative management should be used such as adjusting activity, fixator and drugs; for the patient with unstable form OCD or failing after conservative treatment, surgery should be generally used such as joint clearing, drilling, microfracture method, fixation and transplantation. With the progress of research, stem cell technology and platelet-rich plasma gradually applied in cartilage repair, which will improve the curative effect of OCD, but still further clinical and experimental research, and also a long-term effective follow-up are needed.