Sun Ting-Yi, Hsu Chun-Liang, Tseng Wei-Cheng, Yeh Tsu-Te, Huang Guo-Shu, Shen Pei-Hung
Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
Division of Traumatology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
J Pers Med. 2022 Jun 30;12(7):1076. doi: 10.3390/jpm12071076.
This study aimed to evaluate the different clinical results and factors associated with cartilage defects in military draftees who underwent different treatments after anterior cruciate ligament (ACL) rupture. Overall, 105 patients who had sustained ACL rupture were military draftees who underwent a conscription examination for physical status assessment from January 2012 to December 2020. Patients were divided into three groups: conservative treatment after ACL rupture, status post-anterior cruciate ligament reconstruction (ACLR), but graft rupture, and status post-ACLR with graft intact. Inter-group comparisons and statistical analyses were performed for age, body mass index (BMI), thigh circumference difference, side-to-side difference in anterior knee translation by KT-2000, meniscus tear, and cartilage defect. Multivariate logistic regression analysis was used to determine the factors associated with cartilage defects. The multivariable regression model showed that BMI (odds ratio OR: 1.303; 95% CI: 1.016-1.672; = 0.037), thigh circumference difference (OR: 1.403; 95% CI: 1.003-1.084; = 0.034), tear of lateral meniscus (LM) and medial meniscus (MM) (OR: 13.773; 95% CI: 1.354-140.09; = 0.027), and graft rupture group (OR: 5.191; 95% CI: 1.388-19.419; = 0.014) increased the risk of cartilage defects. There was no correlation between cartilage defects and age, KT-2000 difference, tear of LM or MM, or graft intact group. Progression of osteoarthritis was concerned after ACL rupture, and this study identified several factors of post-ACLR graft rupture, greater thigh circumference difference, BMI, and meniscus tear of both LM and MM affecting cartilage defects, which represent early degenerative osteoarthritis changes of the knee. The results of this study should be customized for rehabilitation and military training, especially in military draftees with ACL injuries.
本研究旨在评估前交叉韧带(ACL)断裂后接受不同治疗的应征入伍军人软骨缺损的不同临床结果及相关因素。总体而言,105例ACL断裂患者为2012年1月至2020年12月期间接受征兵体格检查以评估身体状况的应征入伍军人。患者分为三组:ACL断裂后保守治疗、前交叉韧带重建(ACLR)术后移植物断裂、ACLR术后移植物完整。对年龄、体重指数(BMI)、大腿围度差、KT-2000测量的膝关节前向平移左右侧差异、半月板撕裂和软骨缺损进行组间比较和统计分析。采用多因素逻辑回归分析确定与软骨缺损相关的因素。多变量回归模型显示,BMI(比值比OR:1.303;95%置信区间CI:1.016-1.672;P = 0.037)、大腿围度差(OR:1.403;95%CI:1.003-1.084;P = 0.034)、外侧半月板(LM)和内侧半月板(MM)撕裂(OR:13.773;95%CI:1.354-140.09;P = 0.027)以及移植物断裂组(OR:5.191;95%CI:1.388-19.419;P = 0.014)增加了软骨缺损的风险。软骨缺损与年龄、KT-2000差异、LM或MM撕裂或移植物完整组之间无相关性。ACL断裂后关注骨关节炎的进展,本研究确定了ACLR术后移植物断裂、更大的大腿围度差、BMI以及LM和MM的半月板撕裂等影响软骨缺损的几个因素,这些因素代表了膝关节早期退行性骨关节炎变化。本研究结果应为康复和军事训练量身定制,尤其是对于ACL损伤的应征入伍军人。