The Clinical Study On The Wear Characteristics Of Articular Cartilage Of Medial Tibial Plateau In Knee Osteoarthritis With Anterior Cruciate Ligament Injury

Objective:To explore the role and relative mechanism of the anterior cruciate ligament injury in the development of knee osteoarthritis by studying and analyzing the wear pattern of articular cartilage of medial tibial plateau in patients with or without functional anterior cruciate ligament in patients with degenerative osteoart-hritis of the knee.Materials and methods:From October 2015 to September 2016,50 patients(with 55 knees)who suffered from KOA and underwent total knee arthroplasty in affiliated hospital of shandong university of TCM(Chinese medicine hospital in shandong province)was elected as a research sample.There are 5 men(with 5 knees)and 45 women(with 50 knees)in all of the patients which age from 50 to 76,average age of 60.2 years.According to the different degree of the ACL injury which were seen by the naked eye during operation,it could be divided into 0-?grade,grade 0 10 cases(with 10 knees),grade ? 12 cases(with 14 knees),grade ? 18 cases(with 20 knees),grade ? 8 cases(with 9 knees)grade ? 2 cases(with 2 knees).Using Weidow naked eye classificiation method to analyze all the samples of the study,and the medial tibial plateau was divided into 3 equal areas according to the longest anteroposterior diameter,which was marked as anterior area,central area,posterior area.If the wear of articular cartilage were involved in two areas,which was marked as antero-middle,postero-middle.If the wear of articul-ar cartilage was involved in three areas,which was marked as all areas.All cases were operated by the same operator,the conditions of anterior cruciate ligament and the medial tibial plateau were recorded by the same people,all of which using PS type total knee artifical pros-thesis.Result:According to the naked eye classification of ACL injury and Weidow naked eye classificiation method,all 50 patients(with 55 knees),the average wear classificiation of the medial tibial plateau cartilage was 2.52±0.75 in 10 cases which belonged to grade 0,the average wear classificiation of the medial tibial plateau cartilage was 2.55±0.45 in 14 cases which belonged to grade ?,the average wear classificiation of the medial tibial plateau cartilage was 3.22±0.42 in 20 cases which belonged to grade?,the average wear classificiation of the medial tibial plateau cartilage was 3.72±0.36 in 9 cases which belonged to grade ?,the average classifi-ciation wear of the medial tibial plateau cartilage was 3.85±0.35 in 2 cases which belonged to grade ?.The mean Weidow score of the relative-insufficiency ACL group was 2.68±0.95,The mean Weidow score of the absoluteinsufficiency ACL group was 3.63±0.56.The wear pattern of articular cartilage of medial tibial plateau was distributed mainly antero-middle 2/3 articular surface,followed by was middle 1/3 articular surface,49.1 and 29.1 percent respective-ly.The wear pattern of articular cartilage of medial tibial plateau was distributed mainly postero-middle 2/3 articular surface in 11 knees which were complete ACL tears or loss,accounted for 72.7 percent.Conclusion:We could find that the wear pattern of articular cartilage of medial tibial plateau was distributed mainly in postero-middle area which ACL was insufficient absolutely,and the other was distributed mainly in antero-middle area which ACL was insufficient relatively.The worse anterior cruciate ligament injury,the higher medial tibial plateau cartilage wear.