Magnussen Robert A, Mansour Alfred A, Carey James L, Spindler Kurt P
Department of Orthopaedic Surgery, Division of Sports Medicine, Vanderbilt University Medical Center, Vanderbilt Sports Medicine Center, Nashville, Tenn, USA.
J Knee Surg. 2009 Oct;22(4):347-57. doi: 10.1055/s-0030-1247773.
The development of premature osteoarthritis after anterior cruciate ligament (ACL) reconstruction is a significant cause of morbidity in young, active individuals. Meniscal injuries are frequently noted at the time of reconstruction, and the critical role of an intact meniscus in the prevention of osteoarthritis has been well documented. The purpose of this review is to evaluate the effects of meniscal status at ACL reconstruction on the subsequent development of osteoarthritis. A systematic review of the literature identified 11 studies with > or = 2 years of follow-up that compared patients' radiographic outcomes based on meniscus status at the time of ACL reconstruction. Patients undergoing partial meniscectomy at the time of ACL reconstruction were significantly more likely to develop radiographic evidence of osteoarthritis than those with normal menisci. Meniscal repair resulted in inconsistent findings. Virtually all patients who underwent complete meniscectomy at the time of ACL reconstruction had radiographic evidence of osteoarthritis at follow-up.
前交叉韧带(ACL)重建术后过早发生骨关节炎是年轻活跃个体发病的一个重要原因。在重建时经常会发现半月板损伤,并且完整半月板在预防骨关节炎中的关键作用已有充分记录。本综述的目的是评估ACL重建时半月板状态对随后骨关节炎发展的影响。对文献的系统综述确定了11项随访时间≥2年的研究,这些研究比较了基于ACL重建时半月板状态的患者影像学结果。在ACL重建时接受部分半月板切除术的患者比半月板正常的患者更有可能出现骨关节炎的影像学证据。半月板修复的结果并不一致。实际上,所有在ACL重建时接受完全半月板切除术的患者在随访时都有骨关节炎的影像学证据。