髌内侧滑膜皱襞及对应股骨内侧髁软骨损伤关系探析

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1、離内侧滑膜皱裳及对应股骨内侧髒软骨损伤关系探析作者：李健辉，冯世庆，李建伟，俞汝霞，李伟周先虎【摘要】［目的］探讨離内侧滑膜皱囊的存在、分型与对应股骨内侧課关节软骨损伤之间的关系。［方法］回顾性分析2004年1月-2008年7月所行的膝关节镜探查手术录像资料,共收集到有離内侧滑膜皱裳者76膝作为研究组，记录它们的改良Sakakibara分型与对应股骨内侧課软骨损伤的有无及Outerbridge分级，并按年龄、性别比例相近随机选取80膝无韻内侧滑膜皱裟者作为对照组，研究頤内侧滑膜皱裟与对应股骨内侧課软骨损伤之间的关系。［结果］研究组和对照组相比，股骨内侧髒软骨损伤发生

2、率分别为89.5%和61.3%,差异有统计学意义(P=0.001)；在研究组中BCD型较A型软骨损伤发生率高，分别为95.2%和64.3%,差异有统计学意义(P=0.004)；股骨内侧課软骨损伤程度与離内侧滑膜皱裳炎症程度呈正相关(—0.611,P=0.000),并与患者年龄相关(r=0.271,P=0.019)o［结论］離内侧滑膜皱裳的存在增加了对应股骨内侧髒软骨损伤的危险性;離内侧滑膜皱囊的棚架样外观也是股骨内侧課关节软骨损伤的一个危险因素；股骨内侧課关节软骨损伤程度与離内侧滑膜皱囊病变的严重程度呈正相关。【关键词】膝关节；内侧；滑膜皱叢；关节软骨；损伤Abst

3、ract：[Objective]Tostudytherelationshipbetweentheexistenceandtypesofmediopatellarplicaversusthechondralinjuryofthemedialfemoralcondyle.[Method]DatawerecollectedretrospectivelyfromthephotographicrecordingofarthroscopiesperformedfromJanuary2004toJuly2008・Seventysixkneeswerefoundwithmediop

4、atellarplicaasthestudygroup・ModifiedSakakibaraclassificationandthechondralinjury(usingtheOuterbridgeclassification)ofmedialfemoralcondylewererecorded・Eightykneeswithoutmediopatellarplicawererandomlycollectedascontrols.Thecorrelationofmediopatellarplicaandthecartilageinjuryonthesurfaceo

5、fthemedialfemoralcondylewasinvestigated.[ResuIt]Patientswithmediopatellarplicahadasignificantlyhigherincidencerate(89.5%)ofmedialfemoralcondylecartilagelesion,incomparisonwithpatientswithoutmediopatellarplica(61.3%)(P=0.001).Inthestudygroup,a64.3%proportionofthegroupwithSakakibaraAmedi

6、opatellarplicawasfoundtohavecartilagelesioninthemedialfemoralcondyle.TheproportionofthegroupwithSakakibaraBCDmediopatellarplicawasfoundtobe95.2%,significantlyhigherthanthatinfirstgroup(P=0.004).Theseverityofcartilageinjuryinthemedialfemoralcondylewaspositivelycorrelatedwithpatientage(r

7、=0.271,P=0.019)andtheseverityofthepathologicchangeofthemediopatellarplica(r=0.611,P=0.000).[Conclusion]Accordingtothisobservation,thecartilageinjuryinthemedialfemoralcondyleismorecommonlyfoundinpatientswithmediopatellarplicaknees・Ashelflikeappearanceofthemedialplicacanincreasetheinci