Hagino Tetsuo, Ochiai Satoshi, Senga Shinya, Yamashita Takashi, Wako Masanori, Ando Takashi, Haro Hirotaka
The Sports Medicine and Knee Center, Kofu National Hospital, 11-35 Tenjin-cho, Kofu, Yamanashi, 400-8533, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
Arch Orthop Trauma Surg. 2015 Dec;135(12):1701-6. doi: 10.1007/s00402-015-2309-4. Epub 2015 Aug 19.
To investigate the frequency of meniscal tear and the location of tear associated with anterior cruciate ligament (ACL) injury.
We studied 549 patients (552 knees) who were diagnosed with ACL injury by arthroscopy at our center between January 2006 and March 2014 (8 years and 3 months). The subjects comprised 289 males and 263 females ranging in age from 13 to 66 (mean 26.1) years. The cause of injury was sports-related in 89.1 %, and the mean interval from injury to initial arthroscopy was 23 months. The patients were divided into two groups: arthroscopy performed within 8 weeks after injury (acute group; 256 knees) and more than 8 weeks after injury (chronic group; 296 knees). Frequency of meniscal tear and location of tear were compared between two groups.
The incidence of meniscal tear diagnosed by arthroscopic examination was 79.2 % (437 of 552 knees) in all subjects; 72.7 % (186 of 256 knees) in acute group and 84.8 % (251 of 296 knees) in chronic group, and was significantly higher in chronic group. Regarding the locations of meniscal tears, in acute group (186 knees), medial meniscal tear only was found in 20 knees (10.8 %), lateral meniscal tear only in 129 knees (69.4 %), and bilateral (including medial and lateral) meniscal tears in 37 knees (19.9 %). In chronic group (251 knees), medial meniscal tear only was found in 62 knees (24.7 %), lateral meniscal tear only in 85 knees (33.9 %), and bilateral meniscal tears in 104 knees (41.4 %). Lateral meniscal tear was commonly associated with acute ACL injury, while medial meniscal tear with chronic ACL injury. Bucket handle tear was observed in 25 knees (medial: 17 knees, lateral: 8 knees) in acute group, and 81 knees (medial: 69 knees, lateral: 12 knees) in chronic group, and was more common in the chronic group.
The incidence of meniscal tear associated with ACL injury is higher in chronic cases; the number of medial meniscal tears is particularly high, many of which require meniscectomy. Early ACL reconstruction is recommended also for the prevention of secondary meniscal tear.
探讨半月板撕裂的发生率以及与前交叉韧带（ACL）损伤相关的撕裂部位。
我们研究了2006年1月至2014年3月（8年零3个月）在本中心通过关节镜检查诊断为ACL损伤的549例患者（552膝）。受试者包括289例男性和263例女性，年龄在13至66岁之间（平均26.1岁）。损伤原因与运动相关的占89.1%，从损伤到初次关节镜检查的平均间隔时间为23个月。患者分为两组：损伤后8周内进行关节镜检查的（急性组；256膝）和损伤后8周以上进行关节镜检查的（慢性组；296膝）。比较两组之间半月板撕裂的发生率和撕裂部位。
所有受试者中，经关节镜检查诊断的半月板撕裂发生率为79.2%（552膝中的437膝）；急性组为72.7%（256膝中的186膝），慢性组为84.8%（296膝中的251膝），慢性组明显更高。关于半月板撕裂的部位，在急性组（186膝）中，仅内侧半月板撕裂见于20膝（10.8%），仅外侧半月板撕裂见于129膝（69.4%），双侧（包括内侧和外侧）半月板撕裂见于37膝（19.9%）。在慢性组（251膝）中，仅内侧半月板撕裂见于62膝（24.7%），仅外侧半月板撕裂见于85膝（33.9%），双侧半月板撕裂见于104膝（41.4%）。外侧半月板撕裂常与急性ACL损伤相关，而内侧半月板撕裂与慢性ACL损伤相关。急性组有25膝（内侧：17膝，外侧：8膝）出现桶柄状撕裂，慢性组有81膝（内侧：69膝，外侧：12膝）出现桶柄状撕裂，慢性组更为常见。
与ACL损伤相关的半月板撕裂在慢性病例中的发生率更高；内侧半月板撕裂的数量特别多，其中许多需要半月板切除术。也建议早期进行ACL重建以预防继发性半月板撕裂。
