儿童慢性前交叉韧带撕裂中半月板病理的预测因素：一项病例对照研究
简介
该研究基于儿童ACL登记数据库，纳入347例行ACL重建并伴有半月板病理的患儿，分析年龄、性别、BMI、种族、关节松弛度、关节活动度、骨骼成熟度及手术等待时间等因素对半月板损伤的预测作用。结果显示，58.5%的患者存在半月板病理，其中外侧半月板占53.7%，内侧占26.1%，双侧占20.2%。BMI升高及毛利/太平洋岛民（MPI）种族是独立危险因素：MPI青…
英文摘要
INTRODUCTION: Long-term outcomes following anterior cruciate ligament (ACL) injury in paediatric populations are unclear, with particular concern for post-traumatic osteoarthritis (PTOA). Meniscal pathology is a key predictor of OA and poorer outcomes, frequently occurring alongside ACL injury. This study aims to quantify the risk factors for concomitant meniscal pathology in children and adolescents ACL injury. METHODS: Perioperative data from 347 ACL reconstructions with meniscal pathology were extracted from a paediatric ACL registry. Demographic, injury-related, and physical factors, including age, sex, ethnicity, injury characteristics, body mass index (BMI), leg dominance, Beighton's score, knee extension range of motion, anteroposterior laxity, skeletal maturity, and time to surgery, were analyzed. Univariate and multivariate binomial logistic regression evaluated for predictors of meniscal pathology. RESULTS: Meniscal pathology was present in 58.5% of patients: 53.7% lateral meniscus (LM), 26.1% medial meniscus (MM), and 20.2% both. Increasing BMI and Māori and/or Pacific Islander (MPI) ethnicity were individual predictors of meniscal pathology. MPI adolescents were 4.1-fold increased risk for lateral meniscal injury and a 5-fold increased risk for any tear. Increasing BMI was associated with MM tears (OR 1.19) and combined LM/MM tears (OR 1.31). CONCLUSION: Meniscal pathology is highly prevalent in paediatric ACL injury. Identifying at-risk populations is critical for PTOA prevention and improved long-term outcomes. MPI adolescents with higher BMI may benefit from targeted injury-prevention strategies and counselling on modifiable risk factors.