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国家橄榄球联盟运动员行磁共振成像检查的全层膝关节关节软骨缺损:患病率、部位及与既往手术的关系。

Full-thickness knee articular cartilage defects in national football league combine athletes undergoing magnetic resonance imaging: prevalence, location, and association with previous surgery.

机构信息

Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.

出版信息

Arthroscopy. 2012 Jun;28(6):798-806. doi: 10.1016/j.arthro.2011.11.010. Epub 2012 Feb 4.

Abstract

PURPOSE

To better define the prevalence and location of full-thickness articular cartilage lesions in elite football players undergoing knee magnetic resonance imaging (MRI) at the National Football League (NFL) Invitational Combine and assess the association of these lesions with previous knee surgery.

METHODS

We performed a retrospective review of all participants in the NFL Combine undergoing a knee MRI scan from 2005 to 2009. Each MRI scan was reviewed for evidence of articular cartilage disease. History of previous knee surgery including anterior cruciate ligament reconstruction, meniscal procedures, and articular cartilage surgery was recorded for each athlete. Knees with a history of previous articular cartilage restoration surgery were excluded from the analysis.

RESULTS

A total of 704 knee MRI scans were included in the analysis. Full-thickness articular cartilage lesions were associated with a history of any previous knee surgery (P < .001) and, specifically, previous meniscectomy (P < .001) but not with anterior cruciate ligament reconstruction (P = .7). Full-thickness lesions were present in 27% of knees with a previous meniscectomy compared with 12% of knees without any previous meniscal surgery. Full-thickness lesions in the lateral compartment were associated with previous lateral meniscectomy (P < .001); a similar relation was seen for medial meniscus tears in the medial compartment (P = .01).

CONCLUSIONS

Full-thickness articular cartilage lesions of the knee were present in 17.3% of elite American football players at the NFL Combine undergoing MRI. The lateral compartment appears to be at greater risk for full-thickness cartilage loss. Previous knee surgery, particularly meniscectomy, is associated with these lesions.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

更好地定义在国家橄榄球联盟(NFL)邀请赛联合接受膝关节磁共振成像(MRI)检查的精英足球运动员中全层关节软骨病变的患病率和位置,并评估这些病变与既往膝关节手术的关系。

方法

我们对 2005 年至 2009 年期间在 NFL 联合接受膝关节 MRI 扫描的所有参与者进行了回顾性审查。对每个 MRI 扫描进行了关节软骨疾病的证据审查。记录每位运动员既往膝关节手术的病史,包括前交叉韧带重建、半月板手术和关节软骨手术。既往接受过关节软骨修复手术的膝关节被排除在分析之外。

结果

共纳入 704 例膝关节 MRI 扫描进行分析。全层关节软骨病变与既往任何膝关节手术史相关(P<0.001),特别是既往半月板切除术(P<0.001),但与前交叉韧带重建无关(P=0.7)。与无既往半月板手术的膝关节相比,既往半月板切除术的膝关节中全层病变的发生率为 27%,而无既往半月板手术的膝关节为 12%。外侧间室的全层病变与既往外侧半月板切除术相关(P<0.001);内侧间室的内侧半月板撕裂也存在类似的关系(P=0.01)。

结论

在接受 MRI 检查的 NFL 邀请赛联合接受检查的精英美式足球运动员中,有 17.3%的膝关节存在全层关节软骨病变。外侧间室似乎更容易发生全层软骨丢失。既往膝关节手术,特别是半月板切除术,与这些病变有关。

证据水平

IV 级,治疗性病例系列。

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