性别特异性预测指标与前交叉韧带重建术中观察到的关节内损伤相关。
Sex-Specific Predictors of Intra-articular Injuries Observed During Anterior Cruciate Ligament Reconstruction.
机构信息
University at Buffalo, The State University of New York, Buffalo, New York, USA.
出版信息
Orthop J Sports Med. 2015 Feb 24;3(2):2325967115571300. doi: 10.1177/2325967115571300. eCollection 2015 Feb.
BACKGROUND
Male patients tend to have more meniscal and chondral injuries at the time of anterior cruciate ligament (ACL) reconstruction than females. No studies have examined sex-specific predictors of meniscal and chondral lesions in ACL-injured patients.
PURPOSE
To identify sex-specific predictors of meniscal and chondral lesions, as well as meniscal tear management, in patients undergoing ACL reconstruction.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
Data were collected prospectively from 689 patients (56.2% males) undergoing ACL reconstruction between 2005 and 2014. Predictors of meniscal tears, meniscal tear management, and chondral injuries were determined using multivariate logistic regression models stratified by sex. Predictors were age, body mass index (BMI; 25-29.99 and ≥30 vs ≤24.99 kg/m(2)), mechanism (contact vs noncontact) and type (high-impact sports [basketball, football, soccer, and skiing] and other sports vs not sports-related) of injury, interval from injury to surgery (≤6 vs >6 weeks), and instability episodes (vs none). Odds ratios and 95% CIs were reported.
RESULTS
Males had more lateral (46% vs 27.8%; P < .0001) and medial (40.2% vs 31.5%; P = .01) meniscal tears, as well as more lateral (72.1% vs 27.9%; P < .0001) and medial (61.4% vs 38.6%; P = .01) meniscectomies than females. For males, age predicted chondral injuries and medial meniscectomy; BMI ≥30 kg/m(2) predicted medial meniscal tears; high-impact and other sports predicted medial meniscal tears, medial meniscectomies, and medial meniscal repairs; injuries ≤6 weeks from surgery predicted lateral meniscal repairs; and instability episodes predicted medial meniscal tears, medial tears left in situ, medial meniscectomies, and medial meniscal repairs. For females, age predicted chondral injuries, BMI ≥30 kg/m(2) predicted lateral meniscectomies and repairs, and instability episodes predicted medial meniscectomies.
CONCLUSION
Sex differences were observed. For males, predictors included age, BMI, sports-related injuries, injuries ≤6 weeks from surgery, and instability episodes. For females, predictors included age, BMI, and instability episodes.
背景
与女性相比，前交叉韧带（ACL）重建时男性患者更易发生半月板和软骨损伤。目前尚无研究探讨 ACL 损伤患者中半月板和软骨损伤的性别特异性预测因素。
目的
确定 ACL 重建患者中半月板和软骨损伤以及半月板撕裂处理的性别特异性预测因素。
研究设计
队列研究；证据水平，3 级。
方法
2005 年至 2014 年间，前瞻性收集了 689 例（56.2%为男性）接受 ACL 重建的患者数据。使用多变量逻辑回归模型，按性别分层，确定半月板撕裂、半月板撕裂处理和软骨损伤的预测因素。预测因素包括年龄、体重指数（BMI；25-29.99 和≥30 与≤24.99 kg/m2）、损伤机制（接触与非接触）和类型（高冲击运动[篮球、足球、足球和滑雪]和其他运动与非运动相关）、从损伤到手术的时间间隔（≤6 与>6 周）和不稳定发作（与无不稳定发作）。报告比值比和 95%置信区间。
结果
男性的外侧（46%比 27.8%；P<0.0001）和内侧（40.2%比 31.5%；P=0.01）半月板撕裂以及外侧（72.1%比 27.9%；P<0.0001）和内侧（61.4%比 38.6%；P=0.01）半月板切除术均多于女性。对于男性，年龄预测软骨损伤和内侧半月板切除术；BMI≥30 kg/m2 预测内侧半月板撕裂；高冲击运动和其他运动预测内侧半月板撕裂、内侧半月板切除术和内侧半月板修复；手术时间≤6 周预测外侧半月板修复；不稳定发作预测内侧半月板撕裂、内侧半月板撕裂未处理、内侧半月板切除术和内侧半月板修复。对于女性，年龄预测软骨损伤，BMI≥30 kg/m2 预测外侧半月板切除术和修复，不稳定发作预测内侧半月板切除术。
结论
观察到性别差异。对于男性，预测因素包括年龄、BMI、与运动相关的损伤、手术时间≤6 周和不稳定发作。对于女性，预测因素包括年龄、BMI 和不稳定发作。
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