Maletius W, Messner K
Department of Sports Medicine, University Hospital, Linköping, Sweden.
Am J Sports Med. 1996 May-Jun;24(3):258-62. doi: 10.1177/036354659602400302.
We retrospectively matched 42 patients with unilateral chondral damage in the weightbearing zone of one knee compartment according to sex, age, location of chondral damage, and follow-up time. Two groups of 21 patients were formed. One group had chondral damage only. The other group had chondral damage and a meniscal tear treated with partial meniscectomy. After 12 to 15 years, all patients were reexamined. Twenty-nine percent (N = 6) of the patients who had a partial meniscectomy needed repeat meniscal surgery during followup. No patients with isolated chondral damage developed meniscal symptoms, and only three patients underwent minor surgeries (P < 0.02). At the follow-up evaluation, both groups had similar knee function with a mean Lysholm score of 87 points. However, most patients had reduced their sports activities from competitive individual sports before injury to noncompetitive physical fitness exercise at followup. At the roentgenologic examination, patients who had partial meniscectomies had more severe roentgenologic signs of osteoarthritis than patients who had chondral damage only (P < 0.03). Meniscectomy, varus knee alignment at the follow-up evaluation (P < 0.04), and age older than 30 years (P < 0.04) at the time of the operation were associated with a higher incidence of osteoarthritis.
我们根据性别、年龄、软骨损伤部位和随访时间，对42例单侧膝关节负重区软骨损伤患者进行回顾性匹配。形成了两组，每组21例患者。一组仅患有软骨损伤。另一组患有软骨损伤并伴有半月板撕裂，接受了部分半月板切除术治疗。12至15年后，对所有患者进行复查。接受部分半月板切除术的患者中有29%（N = 6）在随访期间需要再次进行半月板手术。单纯软骨损伤的患者均未出现半月板症状，只有3例患者接受了小型手术（P < 0.02）。在随访评估中，两组的膝关节功能相似，平均Lysholm评分为87分。然而，大多数患者已将运动活动从受伤前的竞技性个人运动减少为随访时的非竞技性健身锻炼。在X线检查中，接受部分半月板切除术的患者比仅患有软骨损伤的患者有更严重的骨关节炎X线征象（P < 0.03）。半月板切除术、随访评估时膝关节内翻（P < 0.04）以及手术时年龄大于30岁（P < 0.04）与骨关节炎的较高发病率相关。
