Fok August W M, Yau W P
Division of Sports and Arthroscopic Surgery, Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
Hong Kong Med J. 2015 Apr;21(2):131-5. doi: 10.12809/hkmj134124. Epub 2014 Dec 19.
To investigate the associations between patient sex, age, cause of injury, and frequency of meniscus and articular cartilage lesions seen at the time of the anterior cruciate ligament reconstruction.
University affiliated hospital, Hong Kong.
Medical notes and operating records of 672 Chinese patients who had received anterior cruciate ligament reconstruction between January 1997 and December 2010 were reviewed. Data concerning all knee cartilage and meniscus injuries documented at the time of surgery were analysed.
Of the 593 patients, meniscus injuries were identified in 315 (53.1%). Patients older than 30 years were more likely to suffer from meniscal injury compared with those younger than 30 years (60% vs 51%, P=0.043). Longer surgical delay was observed in patients with meniscal lesions compared with those without (median, 12.3 months vs 9.1 months, P=0.021). Overall, 139 cartilage lesions were identified in 109 (18.4%) patients. Patients with cartilage lesions were significantly older than those without the lesions (mean, 27.6 years vs 25.1 years, P=0.034). Male patients were more likely to have chondral injuries than female patients (20.1% vs 10.9%, P=0.028). The risk of cartilage lesions was increased by nearly 3 times in the presence of meniscal tear (P<0.0001; odds ratio=2.7; 95% confidence interval, 1.7-4.2).
Increased age and surgical delay increased the risk of meniscal tears in patients with anterior cruciate ligament tear. Increased age, male sex, and presence of meniscal tear were associated with an increased frequency of articular lesions after an anterior cruciate ligament tear.
探讨前交叉韧带重建时患者的性别、年龄、损伤原因与半月板及关节软骨损伤频率之间的关联。
香港大学附属医院。
回顾了1997年1月至2010年12月期间接受前交叉韧带重建的672例中国患者的病历和手术记录。分析了手术时记录的所有膝关节软骨和半月板损伤的数据。
在593例患者中，315例（53.1%）发现有半月板损伤。30岁以上的患者比30岁以下的患者更易发生半月板损伤（60%对51%，P=0.043）。与无半月板损伤的患者相比，有半月板损伤的患者手术延迟时间更长（中位数分别为12.3个月和9.1个月，P=0.021）。总体而言，109例（18.4%）患者发现有139处软骨损伤。有软骨损伤的患者明显比无损伤的患者年龄大（平均年龄分别为27.6岁和25.1岁，P=0.034）。男性患者比女性患者更易发生软骨损伤（20.1%对10.9%，P=0.028）。存在半月板撕裂时，软骨损伤的风险增加近3倍（P<0.0001；比值比=2.7；95%置信区间，1.7 - 4.2）。
年龄增加和手术延迟会增加前交叉韧带撕裂患者半月板撕裂的风险。年龄增加、男性性别以及存在半月板撕裂与前交叉韧带撕裂后关节损伤频率增加有关。
