Timing of Anterior Cruciate Ligament Reconstructive Surgery and Risk of Cartilage Lesions and Meniscal Tears A Cohort Study Based on the Norwegian National Knee Ligament Registry
Timing of Anterior Cruciate Ligament Reconstructive Surgery and Risk of Cartilage Lesions and Meniscal Tears A Cohort Study Based on the Norwegian National Knee Ligament Registry
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DOI：
10.1177/0363546508330136
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发表时间：
2009-05-01
影响因子：
4.8
通讯作者：
Engebretsen, Lars
中科院分区：
文献类型：
--
作者：
Granan, Lars-Petter;Bahr, Roald;Engebretsen, Lars
背景资料：没有足够的证据来确定何时对前交叉韧带缺陷的膝关节进行手术。目的：研究前交叉韧带重建的时机与膝关节撕裂和软骨损伤风险之间的关系。研究设计：队列研究（预后）;证据等级，2.方法：从2004年到2006年，在挪威国家膝关节韧带登记处登记的所有接受过初次前交叉韧带重建的患者，综述Logistic回归分析被用来估计从受伤到前交叉韧带手术的时间之间的关系，并在3475例患者，有909例（26%）与软骨病变，1638例（47%）与前交叉韧带撕裂，和527例（15%）与软骨和前交叉韧带病变的风险。从受伤到手术，成人膝关节（>16岁）软骨损伤的几率每增加1. 006（95%置信区间，1. 003 - 1. 010）。年轻人（17-40岁）的软骨进一步恶化，与患者年龄相关的比值增加1.03（95%置信区间，1.02-1.05）。受伤后每个月，年轻人尿道撕裂的几率增加1.004（95%置信区间，1.002-1.006）。1退行性病变的存在增加的几率有其他退行性病变之间的1.6和2.0在所有patient groups.Conclusion：在成人膝关节软骨病变的几率增加了近1%，每个月过去的损伤日期，直到手术日期和软骨病变的近两倍，如果有一个关节撕裂，反之亦然。
Background: There is inadequate evidence to determine when to perform surgery on anterior cruciate ligament-deficient knees.Purpose: To study the association between timing of anterior cruciate ligament reconstruction and the risk of having meniscal tears and cartilage lesions.Study Design: Cohort study (prognosis); Level of evidence, 2.Methods: All patients registered in the Norwegian National Knee Ligament Registry who had undergone primary anterior cruciate ligament reconstruction from 2004 and throughout 2006 were reviewed. Logistic regression analyses were used to estimate the relationship between time from injury until anterior cruciate ligament surgery and the risk of meniscal tears or cartilage lesions.Results: Of a total of 3475 patients, there were 909 patients (26%) with cartilage lesions, 1638 patients (47%) with meniscal tears, and 527 patients (15%) with both cartilage and meniscal lesions. The odds of a cartilage lesion in the adult knee (>16 years) increased by 1.006 (95% confidence interval, 1.003-1.010) for each month that elapsed from injury to surgery. The cartilage in young adults (17-40 years) deteriorated further with an increase in odds of 1.03 (95% confidence interval, 1.02-1.05) related to the aging in years of the patient. The odds for meniscal tears in young adults increased by 1.004 (95% confidence interval, 1.002-1.006) for each month that elapsed since injury. The presence of 1 degenerative lesion increased the odds of having the other degenerative lesion by between 1.6 and 2.0 in all patient groups.Conclusion: The odds of a cartilage lesion in the adult knee increased by nearly 1% for each month that elapsed from the injury date until the surgery date and that of cartilage lesions were nearly twice as frequent if there was a meniscal tear, and vice versa.