Johnson Victoria L, Guermazi Ali, Roemer Frank W, Hunter David J
Institute of Bone and Joint Research, Kolling Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
School of Medicine, University of Sydney, Sydney, New South Wales, Australia.
Int J Rheum Dis. 2017 Oct;20(10):1361-1371. doi: 10.1111/1756-185X.13003. Epub 2016 Dec 30.
The aim of this study was to examine the difference in the pattern of articular damage in persons with either a partial anterior cruciate ligament (ACL) tear; a complete ACL tear or no ACL tear.
Our study included 600 individuals (of the 600 individuals, 25 with a partial, 12 with a complete ACL tear and 563 with no ACL tear) from the progression sub-cohort of the Osteoarthritis Initiative. Individuals had a mean age of 61.8 years (range 45-79 years). Chi-square tests were used to compare the location of meniscal pathology, bone marrow lesions (BMLs) and regional cartilage morphology between individuals with a partial or complete ACL tear, as seen on magnetic resonance imaging, as well as to a control group of 563 knees.
Individuals with either a complete or partial ACL tear displayed predominantly medial tibiofemoral damage. Individuals with complete ACL tears were more likely to have cartilage lesions in the lateral posterior tibia (P = 0.03) and the medial anterior femur (P = 0.008) as well as BMLs in the medial posterior tibia (P = 0.007). However, no significant difference in meniscal morphology was found in either compartment. Individuals with no history of knee trauma or ACL injury displayed predominantly medial tibiofemoral compartment damage.
Individuals with prevalent ACL disruptions exhibited concomitant osteoarthritic changes in the medial tibiofemoral compartment, as seen on MRI. As the changes in joint tissues were predominantly located in the medial compartment, it is thought that these ACL tears may represent a manifestation of the overall disease process rather than the precipitant for osteoarthritis incidence.
本研究旨在探讨部分前交叉韧带（ACL）撕裂、完全ACL撕裂或无ACL撕裂患者的关节损伤模式差异。
我们的研究纳入了骨关节炎倡议进展亚队列中的600名个体（600名个体中，25名部分ACL撕裂，12名完全ACL撕裂，563名无ACL撕裂）。个体的平均年龄为61.8岁（范围45 - 79岁）。采用卡方检验比较部分或完全ACL撕裂个体与563个膝关节组成的对照组在磁共振成像上半月板病变、骨髓损伤（BMLs）和区域软骨形态的位置。
完全或部分ACL撕裂的个体主要表现为胫股内侧损伤。完全ACL撕裂的个体更有可能在胫骨外侧后部（P = 0.03）和股骨内侧前部（P = 0.008）出现软骨损伤，以及在胫骨内侧后部出现BMLs（P = 0.007）。然而，在任何一个腔室中半月板形态均未发现显著差异。无膝关节创伤或ACL损伤史的个体主要表现为胫股内侧腔室损伤。
如磁共振成像所示，患有普遍性ACL损伤的个体在胫股内侧腔室出现了伴随的骨关节炎改变。由于关节组织的变化主要位于内侧腔室，因此认为这些ACL撕裂可能代表了整体疾病过程的一种表现，而非骨关节炎发病的诱因。
