The Prevalence of Articular Cartilage Changes in the Knee Joint in Patients Undergoing Arthroscopy for Meniscal Pathology
The Prevalence of Articular Cartilage Changes in the Knee Joint in Patients Undergoing Arthroscopy for Meniscal Pathology
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DOI：
10.1016/j.arthro.2012.02.029
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发表时间：
2012-10-01
影响因子：
4.7
通讯作者：
Ciccotti, Michael G.
中科院分区：
文献类型：
--
作者：
Ciccotti, Michael C.;Kraeutler, Matthew J.;Ciccotti, Michael G.
目的：本研究的目的是评估膝关节关节软骨变化的患病率，并分析因关节病理接受关节镜检查的患者发生这些变化的预测因素。方法：2005年3月至2009年6月，1,010例患者接受了资深作者的关节镜下关节切除术或关节修复术。在手术过程中，使用精确的图表仔细记录膝关节关节面变化的存在、位置、大小和Outerbridge等级。计算了6个年龄组的关节软骨变化患病率：20岁以下、20至29岁、30至39岁、40至49岁、50至59岁和60岁或以上。人口统计学数据，包括性别，种族，吸烟状况和体重指数（BMI），从患者图表。结果：总的来说，48%的患者显示内侧间室改变，25%的患者显示外侧间室改变，45%的患者显示髌股间室改变。85%的50 - 59岁患者和86%的60岁或以上患者显示至少1个膝关节间室的关节软骨变化。相比之下，只有13%的年龄小于20岁的患者和32%的年龄在20至29岁的患者显示至少1个房室的变化。年龄与3个关节腔中关节软骨变化的发展之间存在显著相关性（P <0.0001）。BMI与内侧和髌股间室的关节软骨变化也有显著相关性（P <0.0001），但与外侧间室无关（P <0.08）。结论：这项研究表明，在因关节病理而接受关节镜手术的患者中，根据Outerbridge分类定义的关节软骨损伤的患病率很高。与关节软骨损伤相关的风险因素包括年龄增加、BMI升高、内侧间室病变和膝关节挛缩。
Purpose: The purposes of this study were to evaluate the prevalence of articular cartilage changes in the knee joint and to analyze predictive factors for these changes in patients undergoing arthroscopy for meniscal pathology. Methods: Between March 2005 and June 2009, 1,010 patients underwent arthroscopic meniscectomy or meniscal repair by the senior author. During surgery, a precise diagram was used to carefully note the presence, location, size, and Outerbridge grade of changes to the articular surfaces of the knee joint. The prevalence of articular cartilage changes was calculated for 6 age groups: younger than 20 years, 20 to 29 years, 30 to 39 years, 40 to 49 years, 50 to 59 years, and 60 years or older. Demographic data including gender, ethnicity, smoking status, and body mass index (BMI) were acquired from patient charts. Results: Overall, 48% of patients showed changes to the medial compartment, 25% to the lateral compartment, and 45% to the patellofemoral compartment. Eighty-five percent of patients aged 50 to 59 years and 86% of patients aged 60 years or older showed articular cartilage changes to at least 1 knee compartment. In contrast, only 13% of patients aged younger than 20 years and 32% of patients aged 20 to 29 years showed changes to at least 1 compartment. A significant relation was found between age and the development of articular cartilage changes in each of the 3 compartments (P < .0001). BMI was also significantly related to articular cartilage changes in the medial and patellofemoral compartments (P < .0001) but not the lateral compartment (P < .08). Conclusions: This study shows a high prevalence of articular cartilage damage as defined by the Outerbridge classification in patients undergoing arthroscopic surgery for meniscal pathology. Risk factors that correlate with articular cartilage damage include increasing age, elevated BMI, medial compartment pathology, and knee contractures.