Huang Jingmin, Hu Wenjin, Li Dongchao, Zhang Zheng, Wang Haijiao, Li Yuhong, Cao Jiangang, Zhao Qian, Chen Xiao
Department of Sports Injuries and Arthroscopic Branch, Tianjin Hospital, Tianjin, 300211, P. R. China.
Tianjin University of Traditional Chinese Medicine, Tianjin, 300211, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Dec 8;30(12):1478-1482. doi: 10.7507/1002-1892.20160306.
To explore the association of anterior cruciate ligament (ACL) degeneration with intercondylar notch impingement and the medial meniscus tear in knee osteoarthritis (KOA).
Between July 2014 and February 2016, 55 KOA patients (55 knees) with ACL degeneration (degeneration group) and 55 KOA patients (55 knees) without ACL degeneration (control group) were included in the study. No significant difference was found in gender, age, body mass index, and side between 2 groups (>0.05). The notch width index was measured on preoperative MRI to evaluate whether the intercondylar notch was narrow. The location of the medial and lateral meniscus tear and osteophyte of the ACL tibial insertion were observed under arthroscopy, and the incidences of the meniscus tear and osteophyte were calculated.
There was no significant difference in anterior horn and body tear of the medial meniscus and in anterior horn, body, posterior horn, and root tear of the lateral meniscus (>0.05). Significant difference was found in the posterior horn and root tear of the medial meniscus, osteophyte of the ACL tibial insertion, narrow intercondylar notch, and the notch width index between 2 groups (<0.05). The incidence of root tear of the medial meniscus was 53.8% (7/13) in 13 knees with osteophyte of the ACL tibial insertion and was 16.5% (16/97) in 97 knees without osteophyte, showing significant difference (=9.671, =0.002).
There is a strong association of ACL degeneration with posterior horn and root tear of the medial meniscus and intercondylar notch impingement in KOA. And the high incidence of root tear of the medial meniscus in knee is correlated with osteophyte of the ACL tibial insertion.
探讨前交叉韧带(ACL)退变与髁间窝撞击及膝关节骨关节炎(KOA)内侧半月板撕裂之间的关联。
2014年7月至2016年2月,纳入55例伴有ACL退变的KOA患者(55膝)(退变组)和55例不伴有ACL退变的KOA患者(55膝)(对照组)。两组在性别、年龄、体重指数和患侧方面无显著差异(>0.05)。术前通过MRI测量髁间窝宽度指数,以评估髁间窝是否狭窄。在关节镜下观察内侧和外侧半月板撕裂的位置以及ACL胫骨止点处的骨赘,并计算半月板撕裂和骨赘的发生率。
内侧半月板前角和体部撕裂以及外侧半月板前角、体部、后角和根部撕裂在两组间无显著差异(>0.05)。两组在内侧半月板后角和根部撕裂、ACL胫骨止点处骨赘、髁间窝狭窄以及髁间窝宽度指数方面存在显著差异(<0.05)。在13例有ACL胫骨止点处骨赘的膝关节中,内侧半月板根部撕裂的发生率为53.8%(7/13),而在97例无骨赘的膝关节中,发生率为16.5%(16/97),差异有统计学意义(=9.671,=0.002)。
在KOA中,ACL退变与内侧半月板后角和根部撕裂以及髁间窝撞击密切相关。膝关节内侧半月板根部撕裂的高发生率与ACL胫骨止点处骨赘有关联。