Tarazona VP, Azcona CA, Velutini BR

Idioma: Español
Referencias bibliográficas: 30
Paginas: 153-157
Archivo PDF: 272.49 Kb.

RESUMEN

Las lesiones condrales cada día son más frecuentes. Si éstas no son tratadas de manera adecuada, pueden causar secuelas graves. Se presenta el caso de un paciente de 15 años con una lesión condral grado 3 de acuerdo con la clasificación modificada de Outerbridge en la rótula, secundaria a una luxación femororrotuliana postraumática. Se realizó la reparación del ligamento patelofemoral medial y se reimplantó el fragmento condral mediante anclas con sutura sobre una base de un coágulo. El desenlace a los cuatro meses de seguimiento fue satisfactorio, pues el paciente no mostró dolor y sus arcos de movilidad estuvieron completos. El objetivo de este informe es presentar un caso clínico de un paciente con una lesión en el cartílago de la rótula, su manejo y los resultados postoperatorios.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Kingma J, Ten Duis HJ. Injuries due to school sports accidents in 4 to 13-years old children. Percept Mot Skills. 2000; 90: 319-325.

2. Oeppen RS, Connolly SA, Bencardino JT. Acute injury of the articular cartilage and subchondral bone: a common but unrecognized lesion in the immature knee. AJR Am J Roentgenol. 2004; 182 (1): 111-117.

3. Vilchis H, Vega EA, Valle G. Lesión osteocondral de patela reparada mediante sutura. Presentación de caso. Rev Mex Ortop. 2008; 22 (1): 50-54.

4. Seeley MA, Knesek M, Vanderhave KL. Osteochondral injury afteracute patellar dislocation in children and adolescents. J Pediatr Orthop. 2013; 33 (5): 511-518.

5. Salzmann G, Niemeyer P, Hochrein A. Articular cartilage repair of the knee in children and adolescents. Orthop J Sports Med. 2018; 6 (3): 2325967118760190.

6. Kocher MS, DiCanzio J, Zurakowski D. Diagnostic performance of clinical examination and selective magnetic resonance imaging in the evaluation of intraarticular knee disorders in children and adolescents. Am J Sports Med. 2001; 29: 292-296.

7. Tavernier T, Dejour D. Knee imaging: what is the best modality. J Radiol. 2001; 82 (pt 2): 387-405 [en francés].

8. Noyes FR, Stabler CL. A system for grading articular cartilage lesions at arthroscopy. Am J Sports Med. 1989; 17: 505-513.

9. Lohmander LS, Dahlberg L, Ryd L. Increased levels of proteoglycan fragments in knee joint fluid after injury. Arthritis Rheum. 1989; 32: 1434-1442.

10. Camp C, Stuart M, Krych A. Current concepts of articular cartilage restoration techniques in the knee. Sports Health 2014; 6 (3): 265-273.

11. Micheli LJ, Moseley JB, Anderson AF. Articular cartilage defects of the distal femur in children and adolescents: treatment with autologous chondrocyte implantation. J Pediatr Orthop. 2006; 26 (4): 455-460.

12. Alford J, Cole B. Cartilage restoration, Part 1. Am J Sports Med. 2005; 33 (2): 295-306.

13. MacConaill MA. The function of intra-articular fibrocartilages, with special reference to the knee and inferior radioulnar joints. J Anat. 1932; 66: 210-227.

14. Mouzopoulos G, Borbon C, Siebold R. Patellar chondral defects: a review of a challenging entity. Knee Surg Sports Traumatol Arthrosc. 2011; 19 (12): 1990-2001.

15. Alford J, Cole B. Cartilage restoration, Part 2: techniques, outcomes, and future directions. Am J Sports Med. 2005; 33 (3): 443-460.

16. Czitrom AA, Langer F, McKee N. Bone and cartilage allotransplantation: a review of 14 years of research and clinical studies. Clin Orthop Relat Res. 2006; 208: 141-145.

17. Van Jonbergen HP, Poolman RW, van Kampen A. Isolated patellofemoral osteoarthritis. Acta Orthop. 2010; 81 (2): 199-205.

18. Ozturk A, Ozdemir MR, Ozkan Y. Osteochondral autografting (mosaicplasty) in grade IV cartilage defects in the knee joint: 2 to 7 year results. Int Orthop. 2006; 30 (3): 200-204.

19. Sanders TL, Pareek A, Johnson NR. Patellofemoral arthritis after lateral patellar dislocation. Am J Sports Med. 2017; 45 (5): 1012-1017.

20. Cicuttini F, Ding C, Wluka A. Association of cartilage defects with loss of knee cartilage in healthy, middle-age adults: a prospective study. Arthritis Rheum. 2005; 52: 2033-2039.

21. Davies-Tuck ML, Wluka AE, Wang Y. The natural history of cartilage defects in people with knee osteoarthritis. Osteoarthritis Cartilage. 2008; 16: 337-342.

22. Pritsch M, Velkes S, Levy O. Suture fixation of osteochondral fractures of the patella. J Bone Joint Surg Br. 1995; 77-B: 154-155.

23. Kirsch M, Fitzgerald S, Friedman H. Transient patellar dislocation: diagnosis with MR imaging. AJR Am J Roentgenol. 1993; 161 (1): 109-113.

24. Nomura E, Inoue M, Kobayashi S. Long-term follow-up and osteoarthritis change after medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med. 2007; 35 (11): 1851-1858.

25. Van haver A, De Roo K, De Beule M. The effect of trochlear dysplasia on patellofemoral biomechanics: a cadaveric study with simulated trochlear deformities. Am J Sports Med. 2015; 43 (6): 1354-1361.

26. Cugat R, Garcia M, Cusco X. Osteochondritis dissecans: a historical review and its treatment with cannulated screws. Arthroscopy. 1993; 9: 675-684.

27. Kivisto R, Pasanen L, Leppilahti J. Arthroscopic repair of osteochondritis dissecans of the femoral condyles with metal staple fixation: a report of 28 cases. Knee Surg Sports Traumatol Arthrosc. 2002; 10: 305-309.

28. Schwarz C, Blazina ME, Sisto DJ. The results of operative treatment of osteochondritis dissecans of the patella. Am J Sports Med. 1988; 16: 522-528.

29. Sekiya LC, Fontbote CA, Harner CD. Arthroscopically assisted retrograde fixation of patellar osteochondritis dissecans using fluoroscopic guidance: a case report and technical note. Arthroscopy. 2003; 19: E1-E7.

30. Gantenbein B. Mesenchymal stem cells and collagen patches for anterior cruciate ligament repair. World Journal of Stem Cells. 2015; 7 (2): 521.