Lysholm J, Hamberg P, Gillquist J
Department of Orthopaedic Surgery, University Hospital, Linköping, Sweden.
Arthroscopy. 1987;3(3):161-5. doi: 10.1016/s0749-8063(87)80058-0.
The correlation between arthroscopic and radiographic osteoarthrosis was studied in 63 patients (51 +/- 12 years) with degenerative changes in the medial compartment of the knee involving the medial meniscus with or without chondral damage. Chondral damage on arthroscopy was classified in grades 1-3 modified after Outerbridge. The radiographic evaluation was done according to Ahlbäck classification. Twenty-eight patients (44%) did not show any significant chondral damage on arthroscopy (grades 0-1). The radiographic findings in this group were usually normal. Three patients, however, showed a slight narrowing of the medial joint space (Ahlbäck I). All three had severely degenerated menisci, and two of them showed superficial fibrillation of both the tibia and the femur. Twenty-four patients (38%) showed a partial thickness chondral damage with fragmentation of the surface (grade 2). Radiographic findings were usually normal; however, patients with involvement of both the tibia and the femur often showed a joint space narrowing on radiographs. Eleven patients (18%) showed destruction of the cartilage down to subchondral bone (grade 3). The typical radiographic finding was a joint space obliteration (Ahlbäck II). Involvement also of the lateral compartment as assessed on arthroscopy was significantly more common in patients with 2nd and 3rd degree chondral disease and Ahlbäck II and III on radiographs than in those with 2nd and 3rd degree chondral damage and normal radiographs. In all but one of the patients with involvement of both compartments, the lateral compartment was considered normal on radiographic examination.
对63例(年龄51±12岁)膝关节内侧间室出现退变改变、累及内侧半月板且伴有或不伴有软骨损伤的患者,研究了关节镜检查结果与放射学骨关节炎之间的相关性。关节镜下软骨损伤根据Outerbridge改良法分为1 - 3级。放射学评估按照Ahlbäck分类法进行。28例患者(44%)关节镜检查未显示任何明显软骨损伤(0 - 1级)。该组患者的放射学表现通常正常。然而,有3例患者显示内侧关节间隙轻度变窄(Ahlbäck I级)。这3例患者的半月板均严重退变,其中2例患者的胫骨和股骨均出现表面纤维化。24例患者(38%)显示软骨部分厚度损伤且表面有碎片形成(2级)。放射学表现通常正常;然而,胫骨和股骨均受累的患者在X线片上常显示关节间隙变窄。11例患者(18%)显示软骨破坏至软骨下骨(3级)。典型的放射学表现为关节间隙消失(Ahlbäck II级)。关节镜检查评估显示外侧间室也受累的情况,在软骨疾病为2级和3级且放射学表现为Ahlbäck II级和III级的患者中,比软骨损伤为2级和3级但放射学表现正常的患者更常见。在除1例之外的所有双侧间室均受累的患者中,放射学检查时外侧间室被认为正常。