摘要
目的研究前十字韧带(anteriorcruciateligament,ACL)断裂对半月板的影响。方法回顾分析1984年12月～1999年12月间收治的419例ACL断裂患者半月板的损伤情况及其与软骨损伤的关系。结果外侧半月板的损伤率随病程增加无显著变化,而内侧半月板的损伤率随病程增加显著增加,由急性期的31.1%增至亚慢性期的48.2%(P<0.01),又增至慢性期的78.8%(P<0.001)。内侧半月板后角损伤率较前角高,差异有显著性意义(P<0.05)。损伤形态以纵裂最常见,随着病程的增加,半月板损伤也越发复杂。内侧半月板损伤患者的内髁软骨损伤的发生率要高于内侧半月板正常者的内髁软骨损伤发生率,但差异无显著性意义(P>0.05);而外侧半月板损伤患者的外髁软骨损伤的发生率却显著高于外侧半月板正常者,差异有非常显著性意义(P<0.01)。结论ACL断裂可伴发和继发半月板的损害,ACL断裂时伴发的多为外侧半月板的损伤,而继发的半月板损害却以内侧为重。内髁软骨损害主要由股胫关节前后向不稳、异常活动增加造成,而与内侧半月板的损伤关系不大。
Objective To study the influence of the rupture of anterior cruciate ligament(ACL) on the menisci. Methods Four hundred and nineteen consecutive patients with rupture of ACL during December 1984 to December 1999 were included in this study. The incidence of meniscal injuries and the correlation of injuries of menisci and cartilage were investigated. Results The incidence of meniscal injuries was increased from 55.6% in acute to 74.1% in sub chronic and 89.8% in chronic. There were significant differences between each two stages (P< 0.001). In the group with the medial meniscus involved, the incidence of meniscal injuries was 31.1% in acute, 48.2% in sub chronic and 78.8% in chronic (P< 0.01,0.001), which is getting higher with the prolongation of the injury history. While in the lateral meniscus involved group, the incidence of meniscal injuries remained constant. The tear of post horn of meniscus was more common than anterior horn especially on medial side. For both menisci, longitudinal split was the commonest type of injury in acute group, and it remained so in medial as the injury became chronic. When the history of injury got longer, the more complex injuries happened. Cartilage injury in medial condyle could be seen when the medial meniscus was broke, however, statistically, there was no significant difference between meniscus rupture and normal meniscus. In contrast, cartilage injury in lateral condyle did correlate with the lateral meniscus break, both in incidence and the extent of the cartilage damage. Conclusion The rupture of ACL could induce meniscal injuries. The study showed that lateral meniscus was always damaged accompanied with ACL injury and medial meniscus damage followed by ACL injury. It indicated that the cartilage injury in medial condyle was due to the unstable movement of the joint because of the ACL deficiency rather than the broken medial meniscus.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2002年第4期216-219,共4页
Chinese Journal of Orthopaedics
