CAJ | 학술논문

目的：观察前交叉韧带重建术后患者的性别、年龄、胫骨前移度、体质指数和术后时间对2次关节镜检查所见的髌股关节软骨变化情况的影响。方法选取2009年12月至2013年8月北京大学第三医院运动医学研究所前交叉韧带双束重建术后1年以上的患者102例，男71例，女31例，平均年龄27．1岁（16～41岁），行2次关节镜检查时平均术后时间是23（12～51）个月，回顾性分析前交叉韧带重建时和2次关节镜检查时髌骨和滑车软骨损伤情况的改变，以及与患者的性别、年龄、胫骨前移度、体质指数和术后时间的关系。结果前交叉韧带重建术后髌骨和滑车的软骨损伤明显加重。男性和女性患者术后髌骨和滑车软骨损伤加重的差异无统计学意义。与≥30岁的患者相比，＜30岁的患者髌骨软骨损伤的加重比较明显，但差异无统计学意义，滑车软骨损伤加重的差异无统计学意义。 KT-2000测量双膝胫骨前移差值＜3 mm与≥3 mm的患者以及体质指数＜24 kg/m2与≥24 kg/m2的患者之间髌骨和滑车软骨损伤加重的差异均无统计学意义。与前交叉韧带重建术后≥24个月的患者相比，术后＜24个月的患者滑车软骨损伤加重的差异无显著性，但髌骨软骨损伤的加重更明显，差异有统计学意义。结论前交叉韧带重建术后髌股关节软骨的损伤明显加重，术后＜24个月的患者髌骨软骨损伤的加重更明显。
목적：관찰전교차인대중건술후환자적성별、년령、경골전이도、체질지수화술후시간대2차관절경검사소견적빈고관절연골변화정황적영향。방법선취2009년12월지2013년8월북경대학제삼의원운동의학연구소전교차인대쌍속중건술후1년이상적환자102례，남71례，녀31례，평균년령27．1세（16～41세），행2차관절경검사시평균술후시간시23（12～51）개월，회고성분석전교차인대중건시화2차관절경검사시빈골화활차연골손상정황적개변，이급여환자적성별、년령、경골전이도、체질지수화술후시간적관계。결과전교차인대중건술후빈골화활차적연골손상명현가중。남성화녀성환자술후빈골화활차연골손상가중적차이무통계학의의。여≥30세적환자상비，＜30세적환자빈골연골손상적가중비교명현，단차이무통계학의의，활차연골손상가중적차이무통계학의의。 KT-2000측량쌍슬경골전이차치＜3 mm여≥3 mm적환자이급체질지수＜24 kg/m2여≥24 kg/m2적환자지간빈골화활차연골손상가중적차이균무통계학의의。여전교차인대중건술후≥24개월적환자상비，술후＜24개월적환자활차연골손상가중적차이무현저성，단빈골연골손상적가중경명현，차이유통계학의의。결론전교차인대중건술후빈고관절연골적손상명현가중，술후＜24개월적환자빈골연골손상적가중경명현。
Objective To evaluate the effects of age , gender , tibial anterior laxity and time from surgery to follow-up on patellofemoral articular cartilage status after anterior cruciate ligament reconstruction by second-look arthroscopy .Methods A total of 102 patients undergoing arthroscopic anterior cruciate ligament reconstruction received second-look arthroscopy at least one year after operation .There were 71 males and 31 females with an average age of 27.1 (16-41) years.The average time from primary operation to second-look arthroscopy was 23 ( 12 -51 ) months.Arthroscopic evaluations of patella and trochlea cartilage status for all patients were performed at initial anterior cruciate ligament reconstruction and second -look arthroscopy .The effects of age , gender , tibial anterior laxity and time from surgery to follow-up on patellofemoral articular cartilage status were retrospectively examined .Results Patellofemoral articular cartilage degeneration continued to aggravate after anterior cruciate ligament reconstruction .There was no significant gender difference in patella and trochlear cartilage status .The patellar cartilage of patients under 30 years was worse than that of patients aged 30 years and above .Even though there was no significant difference .However , no significant inter-group difference existed in trochlear cartilage damage .With regard to KT-2000 side-to-side differences (0-3 mm vs >3 mm), no significant difference existed in patella and trochlear cartilage status .No significant difference was also found in the status of patella and trochlear cartilage between patients with body mass index under 24 kg/m2 and patients 24 kg/m2 and higher .The patellar cartilage of patients within 24 months after operation was significantly worse than that of patients 24 months and longer .However it did not apply to trochlear cartilage .Conclusion The degeneration of patellofemoral articular cartilage worsens after anterior cruciate ligament reconstruction .And significantly more severe lesions are found in patellar cartilage of patients within 24 months after operation .