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关节内半月板、软骨和前交叉韧带损伤之间的关系:来自1774例膝关节镜检查患者的研究结果及性别评估

The relationship between intra-articular meniscal, chondral, and ACL lesions: finding from 1,774 knee arthroscopy patients and evaluation by gender.

作者信息

Unay Koray, Akcal Mehmet Akif, Gokcen Bahadir, Akan Kaya, Esenkaya Irfan, Poyanlı Oguz

机构信息

Goztepe Training and Research Hospital, Orthopaedics and Traumatology Clinic, Medeniyet University, Istanbul, Turkey.

出版信息

Eur J Orthop Surg Traumatol. 2014 Oct;24(7):1255-62. doi: 10.1007/s00590-013-1309-8. Epub 2013 Sep 29.

Abstract

Knowing the relationship between diagnoses is important in knee arthroscopy in terms of defining possible treatment modalities preoperatively. The purpose of our study was to define the diagnoses made intraoperatively through knee arthroscopy and the relationships between them. We evaluated the results of knee arthroscopies performed over a 10-year period. The sites and sizes of chondral lesions, the existence of anterior cruciate ligament (ACL) injury, and the sites of meniscal lesions were noted for a total of 1,774 patients. The relationships between these lesions were evaluated statistically. Chondral lesions and posterior medial meniscal tears were predominant in females, whereas complete ACL tears were predominant in males. ACL tears were commonly accompanied by medial and lateral meniscal bucket-handle tears. In cases with advanced chondral lesions, medial and lateral posterior meniscal and lateral anterior meniscal tears were more common. According to our results, posterior tears of the medial menisci, medial and lateral femoral condyles, lateral tibial plateau type 3 or 4 cartilage lesions, and the rate of diagnostic arthroscopy were higher in females, while middle substance and bucket-handle tears of medial menisci and total rupture of the ACL were more common in males. ACL injuries were seen to coexist with medial or lateral menisci bucket-handle tears, with no relationship between the site or size of the chondral lesions. A relationship between medial and lateral meniscal tears and the site of femoral and tibial chondral surface lesions was detected.

摘要

就术前确定可能的治疗方式而言,了解诊断之间的关系在膝关节镜检查中很重要。我们研究的目的是确定通过膝关节镜检查术中做出的诊断及其之间的关系。我们评估了10年间进行的膝关节镜检查结果。记录了总共1774例患者软骨损伤的部位和大小、前交叉韧带(ACL)损伤的存在情况以及半月板损伤的部位。对这些损伤之间的关系进行了统计学评估。软骨损伤和后内侧半月板撕裂在女性中占主导地位,而完全性ACL撕裂在男性中占主导地位。ACL撕裂常伴有内侧和外侧半月板桶柄状撕裂。在软骨损伤严重的病例中,后内侧和外侧半月板以及外侧前半月板撕裂更为常见。根据我们的结果,内侧半月板后角撕裂、内侧和外侧股骨髁、外侧胫骨平台3或4型软骨损伤以及诊断性关节镜检查率在女性中较高,而内侧半月板中间部分和桶柄状撕裂以及ACL完全断裂在男性中更为常见。ACL损伤与内侧或外侧半月板桶柄状撕裂并存,软骨损伤的部位或大小之间无关联。检测到内侧和外侧半月板撕裂与股骨和胫骨软骨表面损伤部位之间存在关联。

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