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620例因半月板撕裂接受关节镜手术患者中常见的膝关节骨关节炎体征。

Signs of knee osteoarthritis common in 620 patients undergoing arthroscopic surgery for meniscal tear.

作者信息

Pihl Kenneth, Englund Martin, Lohmander L Stefan, Jørgensen Uffe, Nissen Nis, Schjerning Jeppe, Thorlund Jonas B

机构信息

a Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense , Denmark.

b Lund University , Faculty of Medicine, Department of Clinical Sciences Lund, Orthopedics , Lund , Sweden.

出版信息

Acta Orthop. 2017 Feb;88(1):90-95. doi: 10.1080/17453674.2016.1253329. Epub 2016 Nov 1.

DOI:10.1080/17453674.2016.1253329
PMID:27798972
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5251270/
Abstract

Background and purpose - Recent evidence has questioned the effect of arthroscopic knee surgery for middle-aged and older patients with degenerative meniscal tears with or without concomitant radiographic knee osteoarthritis (OA). We investigated the prevalence of early or more established knee OA and patients' characteristics in a cohort of patients undergoing arthroscopic surgery for a meniscal tear. Patients and methods - 641 patients assigned for arthroscopy on suspicion of meniscus tear were consecutively recruited from February 2013 through January 2015. Of these, 620 patients (mean age 49 (18-77) years, 57% men) with full datasets available were included in the present study. Prior to surgery, patients completed questionnaires regarding onset of symptoms, duration of symptoms, and mechanical symptoms along with the knee injury and osteoarthritis outcome score (KOOS). At arthroscopy, the operating surgeon recorded information about meniscal pathology and cartilage damage. Early or more established knee OA was defined as the combination of self-reported frequent knee pain, cartilage damage, and the presence of degenerative meniscal tissue. Results - 43% of patients (269 of 620) had early or more established knee OA. Of these, a large proportion had severe cartilage lesions with almost half having a severe cartilage lesion in at least 1 knee compartment. Interpretation - Based on a definition including frequent knee pain, cartilage damage, and degenerative meniscal tissue, early or more established knee OA was present in 43% of patients undergoing knee arthroscopy for meniscal tear.

摘要

背景与目的——近期证据对关节镜下膝关节手术治疗伴有或不伴有膝关节影像学骨关节炎(OA)的中老年退行性半月板撕裂的效果提出了质疑。我们调查了因半月板撕裂接受关节镜手术的患者队列中早期或更严重膝关节OA的患病率及患者特征。

患者与方法——2013年2月至2015年1月连续招募了641名因怀疑半月板撕裂而被安排接受关节镜检查的患者。其中,本研究纳入了620名(平均年龄49(18 - 77)岁,57%为男性)有完整数据集的患者。手术前,患者完成了关于症状发作、症状持续时间、机械性症状的问卷以及膝关节损伤和骨关节炎结局评分(KOOS)。在关节镜检查时,主刀医生记录了有关半月板病变和软骨损伤的信息。早期或更严重膝关节OA被定义为自我报告的频繁膝关节疼痛、软骨损伤和退行性半月板组织的存在。

结果——43%的患者(620名中的269名)患有早期或更严重膝关节OA。其中,很大一部分有严重软骨病变,几乎一半的患者至少在1个膝关节腔有严重软骨病变。

解读——基于包括频繁膝关节疼痛、软骨损伤和退行性半月板组织的定义,43%因半月板撕裂接受膝关节镜检查的患者存在早期或更严重膝关节OA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae22/5251270/aa440ba0e27a/iort-88-90.F02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae22/5251270/cbedecd217f2/iort-88-90.F01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae22/5251270/aa440ba0e27a/iort-88-90.F02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae22/5251270/cbedecd217f2/iort-88-90.F01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae22/5251270/aa440ba0e27a/iort-88-90.F02.jpg

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