Roos H, Adalberth T, Dahlberg L, Lohmander L S
Department of Orthopedics, University Hospital, Lund, Sweden.
Osteoarthritis Cartilage. 1995 Dec;3(4):261-7. doi: 10.1016/s1063-4584(05)80017-2.
The degree of cartilage changes by arthroscopic and radiologic examination was evaluated in a retrospective, cross-sectional study of 1012 patients with knee complaints at different times after knee injury. Patients were classified by age, sex, trauma date and type of injury. The condition of the cartilage was graded on a 1-10 scale based on findings at arthroscopy and on weight-bearing radiographs. Patients with injury to the anterior cruciate ligament (isolated or combined with injury to meniscus or collateral ligaments) showed the first radiologic signs (joint space narrowing) of osteoarthritis (OA) at an average age of about 40 years, while patients with isolated meniscus injury had the same stage of disease at an average age of about 50 years. Both study groups displayed the first radiologic signs of OA on average about 10 years after the injury and showed increasingly serious arthroscopic and radiologic signs of joint damage with increased time between injury and examination. For patients who sustained an isolated meniscus injury between the ages of 17 and 30, the average time until development of radiologic signs of OA was about 15 years, while for those who had the same injury over the age of 30, the corresponding time interval was only about 5 years. We conclude from this that knee OA becomes increasingly severe with increased time between joint injury and examination. OA changes appear sooner in older patients with knee injury than in the young.
在一项对1012例膝关节损伤后不同时间出现膝关节不适的患者进行的回顾性横断面研究中，通过关节镜检查和放射学检查评估软骨变化程度。患者按年龄、性别、受伤日期和损伤类型进行分类。根据关节镜检查结果和负重X线片，将软骨状况按1 - 10级进行分级。前交叉韧带损伤（单独或合并半月板或侧副韧带损伤）的患者在平均约40岁时出现骨关节炎（OA）的首个放射学征象（关节间隙变窄），而单纯半月板损伤的患者在平均约50岁时处于相同疾病阶段。两个研究组在受伤后平均约10年出现OA的首个放射学征象，并且随着受伤与检查之间时间间隔的增加，关节镜和放射学检查显示的关节损伤征象越来越严重。对于17至30岁之间发生单纯半月板损伤的患者，出现OA放射学征象的平均时间约为15年，而对于30岁以上发生相同损伤的患者，相应的时间间隔仅约为5年。我们由此得出结论，膝关节OA随着关节损伤与检查之间时间间隔的增加而日益严重。膝关节损伤的老年患者比年轻患者更早出现OA变化。
