| Purpouse:The purpose of the study was to evaluating the meniscus injury and its relationship with related factors after anterior cruciate ligament(ACL)rupture,summarising the pattern and characteristics of meniscus injury,providing the reference for the prevention of ACL rupture,individualized diagnosis and treatment,by researching the influence of ACL breakage caused knee instability on meniscus.Method:Clinical and pathological date of young patients who were diagosised ACL by arthroscope between April 2005 and December 2 from the First Affiliated Hospital of Dalian Medical University were retrospectively analyzed.There were 107 male cases and 26 female cases;the age ranged from 18 to 40 years old and the mean age were 29.16±6.82,11 patients have a high-energy contact damage,122 patients have no contact damage;59 cases have a history of hurt again and 74 cases none.The time from hurt to operation were ranged from 2 month to 14 years,the meam time was 35.06±36.38 months.We take the gender,injury mechanism,the course of the disease,a history of hurt again as independent variables,and the specific parts of the meniscus injury as the dependent variable.The X2 test was used to determine the risk factors for influence meniscus injury,Logistic regression analysis was used to determine the independent risk factors that affect the meniscus injury.Also,the X2 test was used to analysis the relationship between the course and the meniscus injury incidence,specific area.Results:?For male patients,the incidence of ACL was higher than female patients,the difference was statistically significant(x2=8.380,P=0.039);?For patients with a history of hurt again,the incidence of ACL was higher than those who none,the difference was statistically significant(x2=13.166,P=0.004);?For patients with chronic course of the disease,the incidence of ACL was higher and the difference was statistically significant(x2=30.565,P<0.001);?For patients with different injury mechanism,there were no difference in the incidence of ACL(X2=4.538,P=0.209).?The influence of history of hurt again and the course of the disease were the independent risk factor of ACL breakage;for the risk of meniscus injury after ACL,those with a history of hurt again was 1.3-fold increased risk than those none;with the increase of course,a gradual increase in risk for meniscal injury,every increase 1 set of course,a 2.9-fold increased risk of meniscus injury.?The incidence of meniscus instability hurt again was increasing with the increase of the course of the disease.? In different course of disease,the incidence of ACL breakage was different between actue and chronic stage,the incidence was 36.4%,72.7%and 91.0%respectively,the difference was statistically significant.?In different course of disease,the incidence of dual lateral meniscus injury at the same time was different between actue and chronic stage,the incidence was 0?13.6%?35.0%(X2 =20.559,P<0.001)respectively,the difference was statistically significant.? With the increasing of the course of the disease,the incidence of lateral breakagge showed no significant change(x2 = 0.274,P=0.872),? but the incidence of medial meniscus breakage increased from actue to chronic,the incidence was 9.1%,36.4%and 70%respectively and the difference was statistically significant.?In different course of disease,the incidence of medial meniscus breakage was higher than anterior angle,especially in sub-chronic(x2=4.267,P=0.039)and chronic stage(x2=9.287,P=0.004),the difference was statistically significant;?the incidence of medial meniscus relief angle breakage was higher than anterior angle,especially in sub-chronic(X2=4.267,P=0.039)and chronic stage(x2=15.368,P<0.001),the difference was statistically significant;?here have no difference between the body and relief angle of the medial meniscus breakage.?In different course of disease,the incidence of lateral meniscus breakage was higher than anterior angle,especially in sub-chronic stage(x2=6.038,P=0.023),but in chronic stage the incidence have no difference(X2=0.786,P=0.659).?the incidence of medial meniscus relief angle breakage was higher than anterior angle,but there have no difference in sub-chronic(X2=2.933,P=0.198)and chronic stage(X2=3.590,P=0.088).?In different course of the disease,the most comman is longitudinal,the second is composite crack,especially in the medial meniscus,longitudinal cracks are more than the rest of the type of damage.With the extension of course,the meniscus damage degree aggravating gradually,appear serious compound injury.Conclusion:The ACL rupture can cause the knee joint instability hurt again,also with and secondary meniscus injury;the lateral meniscus injury always with the ACL rupture;the injury to the medial meniscus injury always secondary to the meniscus injury again,With the extension of course,the meniscus damage is much more complicated,especially more apparent,to prevent instability hurt secondary to the meniscus injury again,it is important to repair the rupture of ACL and rebuild the stability of the knee joint as soon as possible. |
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