Widener Douglas B, Wilson David J, Galvin Joseph W, Marchant Bryant G, Arrington Edward D
Madigan Army Medical Center, Joint Base Lewis-McCord, Fort Lewis, Washington, U.S.A.
Madigan Army Medical Center, Joint Base Lewis-McCord, Fort Lewis, Washington, U.S.A..
Arthroscopy. 2015 Apr;31(4):680-3. doi: 10.1016/j.arthro.2014.10.006. Epub 2014 Dec 15.
The purpose of this study was to determine the incidence of meniscal injury, specifically medial meniscal injury, in US Army soldiers undergoing revision anterior cruciate ligament (ACL) reconstruction.
A retrospective review was performed of all patients who underwent revision ACL reconstruction from 2002 to 2011 at our institution. A complete chart review was performed to identify the prevalence of meniscal pathology identified at the time of revision ACL surgery. Patient demographic data and meniscal injury patterns were analyzed.
Sixty-seven patients were identified, with a mean age of 28 years. The mean time to revision reconstruction was 67 months. Most patients (64.1%) reported a distinct reinjury. Reinjury was reported as the cause for revision ACL reconstruction in 43 patients. In this subgroup the mean time from reinjury to revision surgery was 13.9 months. Meniscal pathology was identified in 50 patients (74.6%). Medial meniscal tears were noted in 38 patients (56.7%), a rate significantly greater than that previously described (P = .008). Lateral meniscal tears were noted in 26 patients (38.8%), which was similar to previously published data (P = .52).
The prevalence of meniscal injury at the time of revision ACL reconstruction in active-duty US Army soldiers is nearly identical to that of previously published data looking at a civilian population (74.6% v 74%) in the Multicenter ACL Revision Study (MARS) cohort. However, the incidence of medial meniscal injury was greater in the active-duty population than in the civilian population (56.7% v 40%). The observed increase in the prevalence of medial meniscal pathology is likely multifactorial, relating to the unique demands on young military athletes in both combat and training environments, rate of reinjury, and various delays to treatment after reinjury.
Level IV, therapeutic case series.
本研究旨在确定接受翻修前交叉韧带（ACL）重建的美国陆军士兵半月板损伤的发生率，尤其是内侧半月板损伤的发生率。
对2002年至2011年在本机构接受翻修ACL重建的所有患者进行回顾性研究。对病历进行全面审查，以确定翻修ACL手术时发现的半月板病变的患病率。分析患者的人口统计学数据和半月板损伤模式。
共确定67例患者，平均年龄28岁。翻修重建的平均时间为67个月。大多数患者（64.1%）报告有明确的再次受伤情况。43例患者报告再次受伤是翻修ACL重建的原因。在该亚组中，从再次受伤到翻修手术的平均时间为13.9个月。50例患者（74.6%）发现有半月板病变。38例患者（56.7%）发现内侧半月板撕裂，该发生率显著高于先前报道的发生率（P = 0.008）。26例患者（38.8%）发现外侧半月板撕裂，这与先前发表的数据相似（P = 0.52）。
现役美国陆军士兵在翻修ACL重建时半月板损伤的患病率与多中心ACL翻修研究（MARS）队列中先前发表的关于平民人群的数据（74.6%对74%）几乎相同。然而，现役人群中内侧半月板损伤的发生率高于平民人群（56.7%对40%）。观察到的内侧半月板病变患病率的增加可能是多因素的，与战斗和训练环境中年轻军事运动员的独特需求、再次受伤率以及再次受伤后各种治疗延迟有关。
IV级，治疗性病例系列。
