Christoforakis Joseph, Pradhan Ragib, Sanchez-Ballester Jordi, Hunt Neil, Strachan Robin K
Charing Cross Hospital and Ealing Hospital, Orthopaedic Department, London, England.
Arthroscopy. 2005 Nov;21(11):1366-9. doi: 10.1016/j.arthro.2005.08.031.
The objective of the present study was to evaluate whether horizontal cleavage and complex meniscus tears, which are degenerative tears, are associated with an increased incidence of cartilage damage, in comparison with patients having other patterns of meniscal injury.
Case series study.
Data were collected prospectively from 497 consecutive knee arthroscopies carried out from 1997 to 2001. Patient data (age, sex, duration of symptoms, injuries, and possible mechanism of injury), operative details (types and number of portals, equipment used), intra-articular findings (articular, meniscal and synovial lesions, and stability characteristics), and procedures performed were recorded. Articular lesions were noted on anatomic articular maps of the different functional zones using a system that presaged the current Internal Cartilage Repair Society system.
A comparison of patients with horizontal cleavage and complex meniscal tears to patients with other types of meniscal tear showed for the former (1) increased incidence of chondral lesions (88.4% v 69.6%, respectively, P < .001), (2) increased severity--type III and IV Outerbridge classification--of chondral lesions (52.8% v 29.4%, respectively, P < .001), and (3) increased incidence of patients having more than 1 chondral lesion (65.3% v 33%, respectively, P < .001).
Complex and horizontal cleavage meniscal tears are highly associated with an increased incidence and severity of cartilage degeneration compared with other types of meniscal tears. Degenerative meniscus tears are not as benign as was previously thought. New age-related categories of chondral damage are emerging.
Level IV, case series prognostic study.
本研究的目的是评估水平劈裂和复杂半月板撕裂（均为退变性撕裂）与其他半月板损伤模式的患者相比，是否与软骨损伤发生率增加相关。
病例系列研究。
前瞻性收集了1997年至2001年连续进行的497例膝关节关节镜检查的数据。记录患者数据（年龄、性别、症状持续时间、损伤情况及可能的损伤机制）、手术细节（切口类型和数量、使用的设备）、关节内发现（关节、半月板和滑膜病变以及稳定性特征）以及所实施的手术操作。使用一种先于当前国际软骨修复协会系统的系统，在不同功能区的解剖关节图上记录关节病变。
将水平劈裂和复杂半月板撕裂的患者与其他类型半月板撕裂的患者进行比较，结果显示前者：（1）软骨损伤发生率增加（分别为88.4%和69.6%，P <.001）；（2）软骨损伤的严重程度增加——Outerbridge III级和IV级分类（分别为52.8%和29.4%，P <.001）；（3）有多处软骨损伤的患者发生率增加（分别为65.3%和33%，P <.001）。
与其他类型的半月板撕裂相比，复杂和水平劈裂半月板撕裂与软骨退变的发生率和严重程度增加高度相关。退变性半月板撕裂并不像之前认为的那么良性。新的与年龄相关的软骨损伤类别正在出现。
IV级，病例系列预后研究。
