Patellar chondropathy prevalence at anterior cruciate ligament reconstruction: Analysis of 250 cases

Autor: J. Proust, Jean-Louis Charissoux, V. Dmytruk, J.-P. Arnaud, A. Oksman, Christian Mabit
Přispěvatelé: Service de Chirurgie orthopédique et traumatologique [CHU Limoges], CHU Limoges, Service d'Anatomie Pathologique [CHU Limoges], Equipe de Recherche Médicale Appliquée (ERMA), Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Université de Limoges (UNILIM)-CHU Limoges
Rok vydání: 2009
Předmět:
Male
Time Factors
Anterior cruciate ligament reconstruction
medicine.medical_treatment
Severity of Illness Index
Cohort Studies
0302 clinical medicine
MESH: Anterior Cruciate Ligament
Orthopedics and Sports Medicine
Anterior Cruciate Ligament
MESH: Cohort Studies
Fisher's exact test
030222 orthopedics
MESH: Middle Aged
Patella
Middle Aged
musculoskeletal system
medicine.anatomical_structure
MESH: Young Adult
symbols
Female
Cartilage Diseases
Adult
Joint Instability
musculoskeletal diseases
Chondropathy
Facet (geometry)
medicine.medical_specialty
Laxity
ACL deficient knee
Adolescent
Anterior cruciate ligament
MESH: Patella
Young Adult
03 medical and health sciences
symbols.namesake
MESH: Severity of Illness Index
Severity of illness
medicine
Humans
Retrospective Studies
MESH: Adolescent
Chondral damage
MESH: Humans
business.industry
Anterior Cruciate Ligament Injuries
MESH: Time Factors
MESH: Cartilage Diseases
MESH: Adult
MESH: Retrospective Studies
Retrospective cohort study
030229 sport sciences
medicine.disease
MESH: Male
Surgery
MESH: Joint Instability
business
MESH: Female
human activities
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Zdroj: Orthopaedics and Traumatology-Surgery and Research
Orthopaedics and Traumatology-Surgery and Research, Elsevier, 2009, 95 (1), pp.36-9. ⟨10.1016/j.otsr.2008.09.001⟩
ISSN: 1877-0568
DOI: 10.1016/j.otsr.2008.09.001
Popis: Summary Introduction Anterior knee instability caused by anterior cruciate ligament (ACL) deficiency results in meniscal as well as chondral femorotibial and/or femoropatellar damages over a more or less long duration delay. This study's objectives were, in chronically deficient ACL patients, to assess onset delay for developping chondral patella lesions and also analyse these lesions characteristics in relation to laxity duration. Hypothesis Chondral patellar lesions in ACL deficient knees get worse with time. Material and methods We reviewed 250 charts of patients who had undergone arthroscopically assisted surgery for knee anterior laxity. The arthroscopic procedures were conducted between January 1995 and January 2005. Chondral damages were evaluated at surgery according both to International Cartilage Repair Society (ICRS) and Bauer and Jackson classifications. The data were analyzed using the Kruskal-Wallis test and the Fisher exact test. Results Of the 250 analysed charts, 72 patients (28.8%) were found to present chondral patella lesions. The majority of these lesions were superficial and involved the lateral facet area. We observed a statistically significant ICRS worsening grade in relation to laxity duration. Discussion Few publications in the literature report patellar involvement in anterior laxity of the knee. However, our results are comparable to those of the rare series found. The pathomechanics of these lesions has not yet been precisely identified and requires further biomechanical studies. Conclusion Patellar damage is frequent with anterior laxity (28.8% in our series) and duration is correlated with statistically significant aggravation of these lesions. Currently, the assessment of these patellar lesions is considered less important than meniscal and femorotibial lesions, even though the natural history of ACL disruption seems to be evolving toward degeneration of all the compartments of the knee, including the femoropatellar compartment. Level of evidence: level IV. Diagnostic study.
Databáze: OpenAIRE
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