Franzone Jeanne M, Vitale Mark A, Shubin Stein Beth E, Ahmad Christopher S
Department of Orthopaedics, Columbia University, New York, NY 10032, USA.
J Knee Surg. 2012 Nov;25(5):411-6. doi: 10.1055/s-0032-1313747. Epub 2012 May 15.
The purpose of this study was to investigate the association between chronicity of patellar instability on the prevalence, grade, and location of chondral lesions in patients with recurrent patellar instability. Patellofemoral chondral status was documented and graded according to the Outerbridge classification in 38 patients who underwent arthroscopic examination at the time of a medial patellofemoral ligament reconstruction procedure. Chondral lesions of any location were observed in 63.2% of patients. Patellar and trochlear lesions were observed in 57.9 and 13.2% of patients, respectively. There was a significantly higher duration of patellar instability in patients with a trochlear lesion versus those without a trochlear lesion (p < 0.01), and in patients with combined patellar and trochlear lesions versus those without both patellar and trochlear lesions (p < 0.01). There was a significant correlation between chronicity of patellar instability and Outerbridge grade of trochlear chondral injury (p = 0.01). Chi-squared analysis revealed that chronicity of patellar instability greater than 5 years was significantly associated with the likelihood of trochlear lesions (p < 0.05). We conclude that patients with increasing chronicity of patellar instability may have a higher likelihood of and higher grade of patellofemoral chondral injuries, specifically for trochlear lesions.
本研究的目的是调查复发性髌骨不稳定患者中髌骨不稳定的慢性程度与软骨损伤的患病率、分级及位置之间的关联。在38例行内侧髌股韧带重建手术时接受关节镜检查的患者中，根据Outerbridge分类法记录并分级髌股软骨状态。63.2%的患者观察到任何位置的软骨损伤。分别有57.9%和13.2%的患者观察到髌骨和滑车损伤。与无滑车损伤的患者相比，有滑车损伤的患者髌骨不稳定的持续时间显著更长（p<0.01），与无髌骨和滑车联合损伤的患者相比，有髌骨和滑车联合损伤的患者亦是如此（p<0.01）。髌骨不稳定的慢性程度与滑车软骨损伤的Outerbridge分级之间存在显著相关性（p=0.01）。卡方分析显示，髌骨不稳定慢性程度大于5年与滑车损伤的可能性显著相关（p<0. 05）。我们得出结论，髌骨不稳定慢性程度增加的患者髌股软骨损伤的可能性和分级可能更高，特别是滑车损伤。
