Subchondral insufficiency fracture of the knee: a non-traumatic injury with prolonged recovery time.
Subchondral insufficiency fracture of the knee: a non-traumatic injury with prolonged recovery time.
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DOI：
10.1136/bcr-2015-209399
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发表时间：
2015-06-08
期刊：
影响因子：
0.9
通讯作者：
Rubin, Janet E
中科院分区：
文献类型：
--
作者：
Gourlay, Margaret L;Renner, Jordan B;Rubin, Janet E
软骨下功能不全骨折是发生在关节软骨下方的非创伤性骨折。虽然低骨密度可能同时存在，但这并不是大多数患者软骨下骨不全骨折的根本原因。软骨下功能不全骨折的特征是平片平片不明显，而MRI检查可显示广泛的骨髓水肿和软骨下骨质塌陷。本文报告一位51岁的绝经后女性内科医生，在临床工作中因长时间站立而导致膝关节软骨下功能不全骨折。伤后14个 月前采用拐杖负重治疗，4 月时进行粘性补充治疗以治疗骨关节炎，7 月时采用Terparatide治疗以促进骨愈合。到受伤26个月 时，她可以忍受使用织物支撑的独立行走，但在长时间站立时仍感受到轻微的膝关节后外侧疼痛和麻木。
Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Although low bone density may be present concurrently, it is not the underlying cause of subchondral insufficiency fractures in the majority of patients. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow oedema and subchondral bone collapse. This article presents a 51-year-old postmenopausal woman, a physician, who had subchondral insufficiency fractures of the knee associated with prolonged standing during clinical work. She was treated with partial weight bearing on crutches until 14 months after the injury, viscosupplementation at 4 months to treat osteoarthritis and teriparatide treatment to improve bone healing at 7 months. By 26 months after the injury, she tolerated independent walking with a fabric knee support but still experienced mild posterolateral knee pain and numbness on prolonged standing.