Raaijmaakers Martijn, Vanlauwe Johan, Vandenneucker Hilde, Dujardin Jan, Bellemans Johan
University Hospital Pellenberg (KUL), Leuven, Belgium.
Acta Orthop Belg. 2010 Feb;76(1):79-85.
We reviewed all patients of 65 years and older (n=183), who underwent a knee arthroscopy between 2004 and 2005. The purpose of our study was to determine the frequency and severity of cartilage lesions and their influence on short-term clinical outcome. Signs of osteoarthritis (OA) were absent or minor on pre operative plain radiographs in 30.5% of patients, but only 5.3% of patients were found during arthroscopy to have no obvious cartilage lesions. WOMAC and KOOS scores did not clearly correlate with severity of cartilage damage, but some WOMAC and KOOS subscales scored significantly lower when cartilage lesions were located on the lateral side. Forty-one patients eventually underwent TKA after a mean period of 14 months. In conclusion, cartilage lesions were visualized in almost every case even when pre-operative radiographs suggested differently. The higher the Kellgren-Lawrence grade of cartilage lesions on preoperative radiographs, the higher the risk for a TKA in the short term. Forty-seven percent of patients with Kellgren-Lawrence grade 4 lesions needed a TKA during the time period of the study.
我们回顾了2004年至2005年间接受膝关节镜检查的所有65岁及以上患者（n = 183）。我们研究的目的是确定软骨损伤的频率和严重程度及其对短期临床结果的影响。30.5%的患者术前X线平片上无骨关节炎（OA）体征或仅有轻微体征，但关节镜检查时仅发现5.3%的患者无明显软骨损伤。WOMAC和KOOS评分与软骨损伤严重程度无明显相关性，但当软骨损伤位于外侧时，一些WOMAC和KOOS子量表得分显著较低。41例患者在平均14个月后最终接受了全膝关节置换术（TKA）。总之，即使术前X线片显示不同，几乎在每个病例中都能看到软骨损伤。术前X线片上软骨损伤的Kellgren-Lawrence分级越高，短期内进行TKA的风险越高。在研究期间，47%的Kellgren-Lawrence 4级损伤患者需要进行TKA。
