有单侧症状的儿童和青少年双侧膝剥脱性骨软骨炎:流行病学和放射学分析。

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-08-23 eCollection Date: 2023-10-01 DOI:10.1177/18632521231193711
Joseph L Yellin, Robert G Tysklind, Zaamin B Hussain, Evan T Zheng, Benton E Heyworth, Mininder S Kocher
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引用次数: 0

摘要

目的:本研究旨在确定单侧症状患者双侧膝剥脱性骨软骨炎的患病率和特征,并将该队列与单侧疾病患者进行比较。方法:患者记录≤18 2003年至2016年,岁,诊断为剥脱性膝关节骨软骨炎和严格意义上的单侧膝关节疼痛。需要在初次出现后1年内进行对侧(无症状)膝关节成像。通过评估病变的大小、位置和Hefti分期来评估病变特征。记录了手术和非手术治疗。将单侧剥脱性骨软骨炎患者与双侧疾病患者进行比较。结果:80名患者,63名男性(79%),17名女性(21%),平均年龄13.1岁 年龄,包括在内。二十(25%)的表现/症状性病变在磁共振成像中被认为是稳定的。病变大小与Hefti分类呈正相关。12名患者(15%)在对侧影像学检查中发现双侧剥脱性骨软骨炎。双侧和单侧疾病患者的骨骼成熟度没有显著差异。52名单侧疾病患者(77%)接受了手术干预,而9名双侧疾病患者(75%)接受了膝关节手术。在对侧无症状病变的患者中,67%的患者最终接受了对侧膝关节的手术干预。结论:在表现为单侧剥脱性骨软骨炎症状的患者中,双侧疾病的患病率为15%,单侧和双侧剥脱性骨软骨炎病变患者在年龄、性别、身体状况或病变特征方面没有差异。考虑到对侧无症状病变的患病率和所需的干预措施,本研究支持早期双侧膝关节放射学评估。证据级别:四,回顾性病例系列。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Bilateral osteochondritis dissecans of the knee in pediatric and adolescent patients presenting with unilateral symptoms: An epidemiological and radiographic analysis.

Purpose: This study aims to determine the prevalence and characteristics of bilateral osteochondritis dissecans of the knee in patients presenting with unilateral symptoms and compare this cohort to patients with unilateral disease.

Methods: Records of patients ≤18 years old from 2003 to 2016 with a diagnosis of osteochondritis dissecans of the knee and strictly unilateral knee pain were identified. Contralateral (asymptomatic) knee imaging within 1 year of initial presentation was required. Lesion characteristics were evaluated by assessing size, location, and Hefti staging. Both surgical and nonoperative treatments were recorded. Patients with unilateral osteochondritis dissecans were compared to those with bilateral disease.

Results: Eighty patients, 63 males (79%) and 17 females (21%), with an average age of 13.1 years old, were included. Twenty (25%) of the presenting/symptomatic lesions were deemed stable on magnetic resonance imaging. A positive correlation between lesion size and Hefti classification was appreciated. Twelve patients (15%) were found to have bilateral osteochondritis dissecans on contralateral imaging. There was no significant difference in skeletal maturity between patients with bilateral versus unilateral disease. Fifty-two patients (77%) with unilateral disease underwent surgical intervention, while 9 (75%) of those with bilateral disease underwent surgery on either knee. In patients with an asymptomatic contralateral lesion, 67% ultimately underwent surgical intervention on the contralateral knee.

Conclusions: In patients presenting with unilateral osteochondritis dissecans symptoms, there was a 15% prevalence of bilateral disease, with no difference in age, sex, physeal status, or lesion characteristics between patients with unilateral vs bilateral osteochondritis dissecans lesions. Given the prevalence of asymptomatic contralateral lesions and the required intervention, this study supports early bilateral radiologic knee evaluation.

Level of evidence: IV, Retrospective Case series.

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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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