Association of Meniscal Status, Lower Extremity Alignment, and Body Mass Index With Chondrosis at Revision Anterior Cruciate Ligament Reconstruction.
Association of Meniscal Status, Lower Extremity Alignment, and Body Mass Index With Chondrosis at Revision Anterior Cruciate Ligament Reconstruction.
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DOI：
10.1177/0363546515578838
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发表时间：
2015-07
期刊：
影响因子：
--
通讯作者：
Wright RW
中科院分区：
文献类型：
--
作者：
Brophy RH;Haas AK;Huston LJ;Nwosu SK;MARS Group;Wright RW
接受 ACL 修复重建 (rACLR) 的膝盖关节软骨损伤的发生率很高。本研究的目的是检验 rACLR 时软骨病患病率与半月板状态和下肢排列相关的假设。横断面研究。回顾了前瞻性多中心 ACL 修复研究 (MARS) 队列的数据，以确定具有术前下肢对齐片的患者。下肢排列由负重线（WBL）定义为胫骨平台宽度的百分比，同时在手术时记录每个负重室的软骨和半月板状态。构建多变量比例优势模型并针对相关因素进行调整，以检查哪些危险因素与内侧和外侧间室软骨病的程度独立相关。该队列包括 246 名在 rACLR 时进行下肢排列片的患者。患者平均 (SD) 年龄为 26.9 (9.5) 岁，BMI 为 26.4 (4.6)。内侧间室的软骨病（2/3 级：42%，4 级：6.5%）多于外侧间室（2/3 级：26%，4 级：6.5%）。 35% 的患者内侧半月板破裂，16% 的患者外侧半月板破裂。测量的平均 (SD) WBL 为 0.43 (0.13)。内侧间室软骨病与 BMI (p=0.025)、排列 (p=0.002) 和内侧半月板状态 (p=0.001) 相关。 WBL 外侧为 0.625 的膝盖均未出现内侧间室 4 级软骨病。外侧间室软骨病与年龄 (p=0.013) 和外侧半月板状态 (p<0.001) 显着相关。研究发现，拥有“完整”半月板的受试者患软骨病的几率降低了 64-84%。 rACLR 时胫股骨间关节软骨的状态与半月板状态相关。下肢排列和体重指数与内侧间室软骨病相关。提供者和患者在进行 rACLR 时应了解半月板完整性、排列和 BMI 与软骨病的关联。有必要进一步研究优化这些参数的干预措施的潜在益处。
Knees undergoing revision ACL reconstruction (rACLR) have a high prevalence of articular cartilage lesions. The purpose of this study was to test the hypothesis that the prevalence of chondrosis at the time of rACLR is associated with meniscus status and lower extremity alignment. Cross sectional study. Data from the prospective Multicenter ACL Revision Study (MARS) cohort was reviewed to identify patients with pre-operative lower extremity alignment films. Lower extremity alignment was defined by the weight bearing line (WBL) as a percentage of the tibial plateau width, while the chondral and meniscal status of each weight bearing compartment was recorded at the time of surgery. Multivariable proportional odds models were constructed and adjusted for relevant factors in order to examine which risk factors were independently associated with the degree of medial and lateral compartment chondrosis. The cohort included 246 patients with lower extremity alignment films at the time of rACLR. Average (SD) patient age was 26.9 (9.5) years with a BMI of 26.4 (4.6). The medial compartment had more chondrosis (Grade 2/3: 42%, Grade 4: 6.5%) than the lateral compartment (Grade 2/3: 26%, Grade 4: 6.5%). Disruption of the meniscus was noted in 35% of patients on the medial side and 16% in the lateral side. The average (SD) WBL was measured to be 0.43 (0.13). Medial compartment chondrosis was associated with BMI (p=0.025), alignment (p=0.002), and medial meniscus status (p=0.001). None of the knees with the WBL lateral to 0.625 had Grade 4 chondrosis in the medial compartment. Lateral compartment chondrosis was significantly associated with age (p=0.013) and lateral meniscus status (p<0.001). Subjects with ‘intact’ menisci were found to decrease their odds of having chondrosis by 64–84%. The status of articular cartilage in the tibiofemoral compartments at the time of rACLR is related to meniscal status. Lower extremity alignment and BMI are associated with medial compartment chondrosis. Providers and patients should be aware of the association of meniscal integrity, alignment and BMI with chondrosis at the time of rACLR. Further research into the potential benefits of interventions to optimize these parameters is warranted.
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影响因子：
4.8
作者：
Dunn, WR;Wolf, BR;Spindler, KP
通讯作者：
Spindler, KP
影响因子：
4.8
作者：
Lind, Martin;Menhert, Frank;Pedersen, Alma B.
通讯作者：
Pedersen, Alma B.
影响因子：
4.8
作者：
Diamantopoulos, Andreas P.;Lorbach, Olaf;Paessler, Hans H.
通讯作者：
Paessler, Hans H.
影响因子：
5
作者：
DAVIS, MA;ETTINGER, WH;HAUCK, WW
通讯作者：
HAUCK, WW
影响因子：
4.8
作者：
Mina, Curtis;Garrett, William E.;Higgins, Laurence
通讯作者：
Higgins, Laurence