z****n
发帖数: 5870 | 1 还不到40岁。。。。北方人，从小就住在阴冷阴冷的背阴面，一直有关节炎，以前打球的时候保护措施也做得不太好，最近几年走路的时候两腿膝关
节都有声音。平时如果活动多了，就会膝盖不能伸直或者不能弯曲。但是通常，休息休
息就好了。前几天右膝盖忽然不能伸直了，并且到了比较严重的程度，连续几天都不好
。这才去看医生。照了X-ray 和 MRI.以下 是MRI的分析结果。
骨科大夫建议右膝盖手术，他说手术中会：
1）清理骨头表面，让它更光滑
2）清理关节腔内的各种碎片。。。
不知道是不是真的应该动手术。看病折腾了这么几天，现在不知不觉中，右腿又可以伸
直或者弯曲了,只是还不能快走和跑。现在很纠结，不知道是不是应该动这个手术。。
。。。
Small joint effusion is present. Prominent patellofemoral osteophytes are
noted. There is moderate patellofemoral cartilaginous thinning, with areas
of chondral fibrillation and fissuring seen along the patella and femoral
trochlear cartilage. Prominent osteophytes are seen at the intercondylar
notch and tibial eminence. Prominent medial and lateral tibiofemoral
compartment osteophytes are also seen. Severe cartilaginous deficiency is
seen at the medial femoral condyle, with areas of near full-thickness
chondral loss demonstrated centrally, associated with mild subchondral
marrow edema. Slight thinning and T2 hyperintensity of the cartilage of the
medial tibial plateau is noted. Lateral compartment articular cartilage is
largely preserved.
Medial meniscus is intact. There may be degeneration of the posterior horn
of the medial meniscus. There is slight medial pseudoextrusion of the medial
meniscus. Linear T2 hyperintense signal seen in the posterior horn of the
lateral meniscus, not extending to the articular surface, compatible with
degeneration. ACL is intact. PCL is intact.
The extensor mechanism is unremarkable. Patellar retinacula and intact. The
medial collateral ligament is intact and unremarkable. Fibular collateral
ligament and conjoined tendon are intact. Mild edema is noted in the body of
the popliteus. T2 hyperintense 1.1cm septated structure is seen along the
musculotendinous junction of the popliteus, although the tendon of the
popliteus is intact,. Possibliy continuous T2 hyperintense 1.7cm
multiseptated structure is also seen directly posterior to the popliteus
tendon and deep to the lateral head of the gastrocnemius, also perhaps
communicating with the posterior joint.
Impression:
1. Moderate to severe tricompartment osteoarthritis.
2. No evidence of internal derangement.
3. Small joint effusion.
4. Complex cystic structure in the posterior lateral knee, which may
represent a complex ganglion or cystic structure related to prior popliteal
muscle injury. | h*******l
发帖数: 1542 | 2 find a second doctor to check.
if he gives you the same operation plan, you follow their operation plans. | R*******t
发帖数: 367 | 3 Osteoarthritis是关节软骨和骨表面不可逆的磨损，长期的wear and tear。现在是他
tricompartment都发病，表面骨刺越多，摩擦磨损越快。也许现在手术让表面平滑，可
以减缓病程。
他还很年轻，而且已经有比较严重的症状妨碍日常生活了，手术可以考虑啊。如果什么
都不做，腿疼也不会好，只能越来越严重，除非整天坐着不走路不费膝关节了。药疗是
治标不治本。很多Osteoarthritis病人最终还是要人工关节，不过最好尽可能延缓，不
要那么早做吧。 |
|
