Mont Michael A, Elmallah Randa K, Cherian Jeffrey J, Banerjee Samik, Kapadia Bhaveen H
Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
J Arthroplasty. 2016 Jan;31(1):284-9. doi: 10.1016/j.arth.2015.07.010. Epub 2015 Jul 11.
This study assessed gross and histopathological ACL changes in arthritic knees (n=174) undergoing total knee arthroplasty. Histopathological changes were assessed and graded as absent (0), mild (1), moderate (2), or marked (3). These were correlated to demographic and clinical factors, and radiographic evaluations. The ACL was intact in 43, frayed in 85, torn in 15, and absent in 31 knees. Eighty-five percent had histological changes. Overall, there were significant associations between greater age and BMI, and histological changes. Grade IV knees had significantly greater calcium pyrophosphate deposits, microcyst formation, and number of pathologic changes. These correlations may aid decision-making when determining suitability for unicompartmental or bicruciate-retaining arthroplasties, though further studies should correlate these histological findings to mechanical and functional knee status.
本研究评估了接受全膝关节置换术的患有关节炎膝关节（n = 174）的大体和组织病理学前交叉韧带（ACL）变化。对组织病理学变化进行评估并分级为无（0）、轻度（1）、中度（2）或重度（3）。将这些变化与人口统计学和临床因素以及影像学评估相关联。43个膝关节的ACL完整，85个磨损，15个撕裂，31个缺如。85%有组织学变化。总体而言，年龄较大和体重指数较高与组织学变化之间存在显著关联。IV级膝关节有明显更多的焦磷酸钙沉积、微囊肿形成和病理变化数量。这些相关性在确定单髁或保留双交叉韧带置换术的适用性时可能有助于决策，不过进一步的研究应将这些组织学发现与膝关节的力学和功能状态相关联。
