Roos H, Laurén M, Adalberth T, Roos E M, Jonsson K, Lohmander L S
Lund University Hospital, Sweden.
Arthritis Rheum. 1998 Apr;41(4):687-93. doi: 10.1002/1529-0131(199804)41:4<687::AID-ART16>3.0.CO;2-2.
To study the long-term outcome of surgical removal of a meniscus in the knee with regard to radiographic signs of osteoarthritis (OA).
Of the 123 patients who underwent an open meniscectomy due to an isolated meniscus tear in 1973 at Lund University Hospital, 107 were followed up 21 years later by clinical examination and by review of knee radiographs obtained with weight bearing. Seventy-nine of the 107 patients were men, and the mean age of the total study group at examination was 55 years (range 35-77). Sixty-eight sex- and age-matched individuals with healthy knees served as controls.
Mild radiographic changes were found in 76 (71%) of the knees, while more advanced changes, comparable with a Kellgren-Lawrence grade of 2 or higher, were seen in 51 (48%). The corresponding prevalence values in the control group were 12 (18%) and 5 (7%), respectively. The relative risk for the presence of the more advanced radiographic changes representing definite radiographic tibiofemoral OA was 14.0 (95% confidence interval 3.5-121.2), using age- and sex-matched pairs for comparison. No correlation with sex, localization to compartment, type of meniscus tear, or work load was found. Knee symptoms were reported twice as often in the study group as in the controls.
Surgical removal of a meniscus following knee injury represents a significant risk factor for radiographic tibiofemoral OA, with a relative risk of 14.0 after 21 years.
研究膝关节半月板手术切除的长期预后与骨关节炎（OA）影像学表现之间的关系。
1973年在隆德大学医院因单纯半月板撕裂接受开放式半月板切除术的123例患者中，107例在21年后接受了临床检查，并复查了负重位膝关节X线片。107例患者中79例为男性，研究组检查时的平均年龄为55岁（范围35 - 77岁）。68名年龄和性别匹配的膝关节健康个体作为对照。
76例（71%）膝关节出现轻度影像学改变，而51例（48%）出现更严重的改变，相当于Kellgren - Lawrence分级2级或更高。对照组相应的患病率分别为12例（18%）和5例（7%）。采用年龄和性别匹配的配对进行比较，出现代表明确胫股关节OA的更严重影像学改变的相对风险为14.0（95%置信区间3.5 - 121.2）。未发现与性别、病变部位、半月板撕裂类型或工作量相关。研究组报告的膝关节症状是对照组的两倍。
膝关节损伤后半月板手术切除是胫股关节OA影像学表现的一个重要危险因素，21年后相对风险为14.0。
