Department of Orthopedics and Traumatology, Faculty of Medicine, University of Pamukkale, Denizli, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2013 May;21(5):1104-10. doi: 10.1007/s00167-012-2081-8. Epub 2012 Jun 12.
To assess the distal femoral cartilage after unilateral arthroscopic partial meniscectomy and to explore the relationship between cartilage thickness and various disease-/surgery-related parameters.
Eighty-nine patients (42 M, 47 F) who had undergone arthroscopic partial meniscectomy surgery were evaluated. Ultrasonographic distal femoral cartilage thicknesses were measured with a 5-13-MHz linear probe (General Electric, Logiq P5) on mid-points of the lateral condyle, intercondylar notch and medial condyle of operated and non-operated knees by a physician blinded to patients' data. Demographic features, duration after surgery, type of meniscal tear and site of meniscectomy were recorded.
Mean age of the patients was 51.8 ± 12.8 years (range 18-88). Mean body mass index was 29.4 ± 4.4 kg/m2 (range 18-38). Overall, in patients with degenerative meniscal tears, femoral cartilage thicknesses pertaining to all the three measured sites (lateral, intercondylar and medial) were found to be decreased in the operated knees when compared with those of the non-operated knees (p = 0.004, p = 0.003, p = 0.041, respectively), whereas in patients with non-degenerative tears, this decrease was significant only in the intercondylar area (p = 0.038). When patients were grouped according to the duration (months) after their surgery (≤36, 37-48 and ≥49), cartilage thickness was similar between both knees in the first group, decreased at the lateral condyle (p = 0.008) and intercondylar area (p = 0.049) in the second group and decreased at all three sites (lateral, intercondylar and medial) in the third group (p = 0.015, p = 0.005 and p = 0.008, respectively).
These findings would be considered as unfavourable with respect to weight-bearing, and thus, conservative measures to support relevant joints would strongly be kept in mind during clinical practice. Lastly, ultrasonography may be a convenient alternative imaging method for the evaluation of short- and medium-term cartilage loss in patients with arthroscopic partial meniscectomy.
III.
评估单侧关节镜下部分半月板切除术（arthroscopic partial meniscectomy，APM）后股骨远端软骨的情况，并探讨软骨厚度与各种疾病/手术相关参数之间的关系。
对 89 例（42 例男性，47 例女性）接受关节镜下部分半月板切除术的患者进行评估。使用 5-13MHz 线性探头（通用电气，Logiq P5）在手术侧和非手术侧膝关节的外侧髁、髁间窝和内侧髁中点测量股骨远端软骨厚度，由一名对患者数据不知情的医生进行操作。记录患者的人口统计学特征、术后时间、半月板撕裂类型和半月板切除术部位。
患者平均年龄为 51.8 ± 12.8 岁（范围 18-88 岁）。平均体重指数为 29.4 ± 4.4kg/m2（范围 18-38kg/m2）。总体而言，在退行性半月板撕裂患者中，与非手术侧相比，所有三个测量部位（外侧、髁间窝和内侧）的股骨软骨厚度在手术侧均变薄（p=0.004、p=0.003、p=0.041），而非退行性撕裂患者中仅在髁间窝区域变薄（p=0.038）。根据术后时间（月）将患者分为≤36、37-48 和≥49 组，第 1 组双膝之间软骨厚度相似，第 2 组外侧髁（p=0.008）和髁间窝（p=0.049）变薄，第 3 组所有三个部位（外侧、髁间窝和内侧）变薄（p=0.015、p=0.005 和 p=0.008）。
这些发现与负重有关，应视为不利因素，因此，在临床实践中应牢记对相关关节的保守治疗措施。最后，超声检查可能是评估关节镜下部分半月板切除术后短期和中期软骨丢失的一种方便的替代影像学方法。
III 级。
