Chavez Audrie, Jimenez Andrew E, Riepen Dietrich, Schell Benjamin, Khazzam Michael, Coyner Katherine J
Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA.
Orthop J Sports Med. 2020 Dec 11;8(12):2325967120967120. doi: 10.1177/2325967120967120. eCollection 2020 Dec.
Previous research has shown that meniscal and articular cartilage lesions increase with time in the anterior cruciate ligament (ACL)-deficient knee.
To analyze the association between increased time from ACL injury to reconstruction and the presence of intra-articular lesions.
Cross-sectional study; Level of evidence, 3.
A retrospective chart review was performed for patients who sustained an ACL injury and underwent reconstruction from January 1, 2009, to May 14, 2015. Factors analyzed included age, sex, and body mass index, as well as time from injury to surgery, the presence of meniscal tears, and the presence of cartilage lesions. The data were evaluated to quantify the association between time from ACL injury to reconstruction and presence of intra-articular lesions.
Overall, 405 patients were included in this study. Regarding time from injury, 27.3% patients were treated at <3 months, 23.6% at 3 to <6 months, 18% at 6 to <12 months, 13.6% at 12 to <24 months, 10.6% at 24 to <60 months, and 6.9% at ≥60 months. When compared with the group treated <3 months from injury, a significant increase in the rate of medial meniscal tears was seen in the groups treated at 6 to <12 months (odds ratio [OR], 2.2), 12 to <24 months (OR, 3.5), 24 to <60 months (OR, 7.0), and ≥60 months (OR, 6.3). A similar trend was seen with medial femoral condyle lesions in the groups treated at 6 to <12 months (OR, 2.5), 12 to <24 months (OR, 2.6), 24 to <60 months (OR, 2.6), and ≥60 months (OR, 6.9). The prevalence of lateral tibial plateau and lateral femoral condyle lesions also significantly increased with increased time between ACL injury and reconstruction, but this association was not seen until 24 to <60 months (ORs, 5.1 and 11.5, respectively).
For patients undergoing ACL reconstruction, an interval >6 months between injury and surgery was associated with an increased prevalence of medial meniscal tears and medial compartment chondral lesions at the time of surgery. An interval >24 months between injury and surgery was associated with an increased prevalence of lateral compartment chondral lesions at the time of surgery.
既往研究表明，前交叉韧带（ACL）损伤的膝关节中，半月板和关节软骨损伤会随时间增加。
分析从ACL损伤到重建的时间延长与关节内损伤存在之间的关联。
横断面研究；证据等级为3级。
对2009年1月1日至2015年5月14日期间发生ACL损伤并接受重建的患者进行回顾性病历审查。分析的因素包括年龄、性别、体重指数，以及从损伤到手术的时间、半月板撕裂的存在情况和软骨损伤的存在情况。对数据进行评估，以量化从ACL损伤到重建的时间与关节内损伤存在之间的关联。
总体而言，本研究纳入了405例患者。关于损伤后的时间，27.3%的患者在<3个月时接受治疗，23.6%在3至<6个月时接受治疗，18%在6至<12个月时接受治疗，13.6%在12至<24个月时接受治疗，10.6%在24至<60个月时接受治疗，6.9%在≥60个月时接受治疗。与损伤后<3个月接受治疗的组相比，在6至<12个月（优势比[OR]，2.2）、12至<24个月（OR，3.5）、24至<60个月（OR，7.0）和≥60个月（OR，6.3）接受治疗的组中，内侧半月板撕裂的发生率显著增加。在6至<12个月（OR，2.5）、12至<24个月（OR，2.6）、24至<60个月（OR，2.6）和≥60个月（OR，6.9）接受治疗的组中，股骨内侧髁损伤也呈现类似趋势。外侧胫骨平台和股骨外侧髁损伤的患病率也随着ACL损伤与重建之间时间的增加而显著增加，但这种关联直到24至<60个月时才出现（OR分别为5.1和11.5）。
对于接受ACL重建的患者，损伤与手术之间间隔>6个月与手术时内侧半月板撕裂和内侧间室软骨损伤的患病率增加相关。损伤与手术之间间隔>24个月与手术时外侧间室软骨损伤的患病率增加相关。
