Lateral ligament injury of the ankle and associated articular cartilage degeneration in the talocrural joint: anatomic study using elderly cadavers
Lateral ligament injury of the ankle and associated articular cartilage degeneration in the talocrural joint: anatomic study using elderly cadavers
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DOI：
10.1007/s00776-003-0732-9
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发表时间：
2004-01-01
影响因子：
1.7
通讯作者：
Yamashita, T
中科院分区：
文献类型：
--
作者：
Hirose, K;Murakami, G;Yamashita, T
我们研究了退行性变化（DC）的关节软骨使用33具尸体距小腿关节。前距腓韧带损伤对照组（93例正常踝关节）与损伤组年龄和性别相匹配。损伤韧带内可见不规则的胶原纤维束，呈波浪状，并伴有玻璃样变（或延长）或断裂伴瘢痕。在这两组中，我们发现距骨侧占主导地位的DCs，多灶性发生，并在关节内侧部分镜像DCs的发病率很高。然而，镜像病变是多个或大（或两者兼而有之）在损伤组相比，其局限性的控制。因此，受伤组受影响区域或部门的平均数量几乎是对照组的两倍。损伤组外踝关节面DCs的发生率明显增高，尤其是镜像病变。虽然最初的DC病变可能是在关节的内侧部位，如在对照组中假设的，外侧韧带损伤似乎增加了DC在外侧部位的优势。因此，对外侧韧带功能不全的早期评估和治疗在老年患者中比在年轻患者中更有必要，以避免骨关节炎的广泛发展。
We investigated degenerative changes (DCs) of the articular cartilage using 33 cadaveric talocrural joints. with anterior talofibular ligament injuries. The control group (93 normal ankles) were age- and sex-matched with the injury group. The injured ligament carried unusual wavy collagen bundles with hyalinization (or elongation) or rupture with scar. In both groups, we found talar-side dominance of DCs, multifocus occurrence, and a high incidence of mirror-image DCs in the medial parts of the joint. However, the mirror-image lesion was multiple or large (or both) in the injury group in contrast to its restricted nature in the control. Thus, the averaged numbers of affected areas or sectors in the injury group were almost twice as large as in the controls. A significantly high incidence of DCs, especially of the mirror-image lesion, was found in the lateral malleolar facet in the injury group. Although initial DC lesions might be at a medial site in the joint, as hypothesized in the control group, the lateral ligament injury seemed to increase the dominance of DCs on the lateral site. Consequently, early evaluation and treatment for lateral ligament insufficiency is more necessary in elderly patients than in younger patients to avoid widespread development of osteoarthritis.