前交叉韧带断裂损伤后并发关节软骨损伤的相关因素研究  

Relative factors of complicated articular cartilage injury after anterior cruciate ligament rupture

作　　者：金伟林[1] 程亚栋[1] 曾冠楠[1] 崔浩[1] 刘振 JIN Wei-lin;CHENG Ya-dong;ZENG Guan-nan;CUI Hao;LIU Zhen(Department of Orthopaedics,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China;Public People's Hospital of Xinzheng,Xinzheng,Henan 455150,China)

机构地区：[1]郑州大学附属郑州市中心医院骨科,郑州450007 [2]新郑市公立人民医院,河南新郑451150

出　　处：《创伤外科杂志》2020年第8期588-591,共4页Journal of Traumatic Surgery

摘　　要：目的探讨前交叉韧带(ACL)断裂损伤后并发关节软骨损伤的相关因素。方法回顾性分析2016年7月—2019年1月郑州市中心医院骨科收治的80例ACL断裂行膝关节镜下ACL重建术患者临床资料,男性61例,女性19例;年龄18~37岁,平均28. 7岁。合并半月板损伤41例。根据是否发生关节软骨损伤(术中关节镜下观察到软骨出现表层纤维化、薄片状剥落、龟裂或下骨暴露等作为关节软骨损伤)分为软骨损伤组(46例)和软骨未损伤组(34例),采用多因素Logistic回归分析ACL断裂后并发软骨损伤的相关因素,采用Spearman相关性分析相关因素与软骨损伤程度的关系。结果 80例ACL断裂患者并发关节软骨损伤46例(58%,CI:3. 662~5. 871),单因素分析发现,受伤时间、接触性损伤、扭伤次数、并发半月板损伤是影响ACL损伤后并发关节软骨损伤的相关因素(P <0. 05);多因素Logistic回归分析显示,受伤时间(> 16. 88d)、扭伤次数(> 1. 10次)、并发半月板损伤是影响ACL损伤后并发关节软骨损伤的独立危险因素(P <0. 05);Spearman相关性分析显示,受伤时间、扭伤次数与软骨损伤程度均呈正相关(r=0. 366、0. 796,P <0. 05)。结论受伤时间> 16d、扭伤次数> 1次、并发半月板损伤与膝关节镜治疗ACL断裂损伤后并发关节软骨损伤相关,临床应及时进行ACL重建,特别是并发半月板损伤患者要避免再次扭伤,从而减少关节软骨损伤的发生。Objective To investigate the relative factors of complicated articular cartilage injury following anterior cruciate ligament( ACL) rupture. Methods A retrospective analysis was performed in 80 patients with ACL rupture( 41 patients with meniscus injury) who underwent knee arthroscopic ACL reconstruction from Jul. 2016 to Jan. 2019. There were 61 males and 19 females,with an average age of 28. 7 years( 18-37 years). According to whether there was articular cartilage injury( articular cartilage injury was diagnosed when the cartilage surface fibrosis,flaky peeling,cracking or exposure of the lower bone were observed under arthroscopy). They were divided into the cartilage injury group( 46 cases) and the cartilage non-injury group( 34 cases). The relative factors of complicated cartilage injury following ACL rupture were analyzed by multivariate Logistic regression. The relationship between the relative factors and the degree of cartilage injury was analyzed by Spearman correlation. Results Among the 80 patients with ACL rupture,46( 58%,95% CI: 3. 662-5. 871) had articular cartilage injury. Univariate analysis showed that the time of injury( > 16. 88 d),contact injury,the times of sprains( > 1. 10 times),and the combined meniscus injury were related factors affecting articular cartilage injury after ACL injury( P < 0. 05);multivariate Logistic regression analysis showed that the time of injury( > 16. 88 d),the number of sprains,and the combined meniscus injury were the independent risk factors for the development of concomitant articular cartilage injury after ACL injury( P < 0. 05). Spearman correlation analysis showed that the time of injury and the number of sprains were positively correlated with the degree of cartilage injury( r = 0. 366,0. 796,P < 0. 05). Conclusion The time of injury( > 16. 88 d),the number of sprains( > 1. 10 times) and the meniscus injury are the relative factors affecting the concomitant articular cartilage injury after ACL rupture by knee arthroscopy. In clinical work,ACL reconstruction s

关 键 词：前交叉韧带断裂 关节软骨损伤 膝关节镜 

分 类 号：R684[医药卫生—骨科学]