运动活动水平与手术时机对前交叉韧带损伤合并病变的独立影响
简介
本研究回顾性分析了2018-2022年间582例（中位年龄26岁）初次ACL重建患者，旨在探讨ACL损伤合并的半月板及软骨损伤情况，并评估运动水平与手术时机对其分布的独立影响。 结果显示，55%的患者存在至少一处半月板撕裂，16%存在软骨损伤（最常见于股骨内髁）。多因素回归分析表明，专业运动员发生外侧半月板后角撕裂的几率更高。手术延迟（伤后超过30天）与软骨…
英文摘要
PURPOSE: To investigate anterior cruciate ligament (ACL) injury associated meniscal and cartilage lesions and to evaluate the independent effects of sports activity level and surgical timing on their distribution. METHODS: A retrospective cohort analysis was conducted on all primary ACL reconstructions performed at a specialized sports medicine hospital between 2018 and 2022. The primary outcome was the prevalence of ACL-associated injuries. Secondary outcomes included classification of associated injuries, differences according to sports activity level, and injury-to-surgery time. Multivariate logistic regression was used as the main analysis. RESULTS: A total of 582 patients were included, with a median age of 26.0 years. Of these, 321 (55%) had at least one meniscal tear. Cartilage lesions were identified in 93 patients (16%), most commonly affecting the medial femoral condyle (MFC). Registration in a professional sports club was associated with increased odds of lateral meniscus posterior horn tears. Surgical delay showed increasing odds of chondral lesions, particularly involving the MFC, as well as medial meniscal tears. Surgeries performed more than 30 days after injury were associated with significantly lower odds of identifying ramp lesions. CONCLUSION: ACL injuries are frequently associated with a range of concomitant intra-articular lesions. Medial compartment lesions are primarily associated with surgical timing, independent of sports activity level. In contrast, lateral meniscus posterior horn tears were more common among professional athletes. Surgeries performed within 30 days of injury were associated with higher odds of detecting ramp lesions, regardless of sports activity level.