| 创伤后膝骨关节炎发展中前交叉韧带损伤的作用与意义#br# |
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| 引用本文： | 韩广弢,李皓桓,高冯. 创伤后膝骨关节炎发展中前交叉韧带损伤的作用与意义#br#[J]. 中国组织工程研究, 2020, 24(15): 2440-2446. DOI: 10.3969/j.issn.2095-4344.2629 |
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| 作者姓名： | 韩广弢 李皓桓 高冯 |
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| 作者单位： | 武汉大学人民医院骨科，湖北省武汉市 430060 |
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| 基金项目： | 国家自然科学基金(81171760)，项目负责人：李皓桓;湖北省自然科学基金(2017CFB700)，项目负责人：李皓桓~~ |
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| 摘 要： | 文题释义：创伤后骨关节炎：又称外伤性骨关节炎、损伤性骨关节炎，它是由创伤引起的以关节软骨的退化变性和继发的关节周围骨质增生为主要病理变化，以关节疼痛、活动障碍为主要临床表现的一种疾病。任何年龄组均可发病，但以青壮年多见，多发于创伤后、承重失衡及活动负重过度的关节。前交叉韧带损伤：一般出现在体育运动中，橄榄球、篮球、足球、滑雪等项目尤其多见。除了膝关节与他人碰撞致伤外，78%的前交叉韧带损伤为非接触性，常发生于落地、急停及暴力扭转等动作。足球运动中，移位防守以及奔跑中踢球相对危险；篮球运动中，侧跳转身以及单腿落地相对危险；在滑雪运动中滑雪板前端受阻时，膝关节外翻旋转，是较为典型的前交叉韧带非接触性损伤机制。背景：前交叉韧带具有稳定膝关节、限制胫股关节在胫骨前平移和旋转的作用，大多数前交叉韧带重建患者膝关节疼痛和膝关节不稳的概率增加。创伤后膝骨关节炎是前交叉韧带损伤后的严重并发症，目前其机制尚不完全清楚。目的：综述前交叉韧带损伤与创伤后膝骨关节炎发病因素之间的关系，从而为创伤后膝骨关节炎的治疗提供帮助。方法：第一作者应用计算机检索PubMed数据库自建库以来至2019年10月的相关文章，英文检索词“ACL injury，traumatic knee osteoarthritis，ACL reconstruction，meniscus status，body mass index，cartilage injury，age，graft selection，time interval between injury and surgery”。共检索到123篇相关文献，66篇文献符合纳入标准。结果与结论：①半月板状态、体质量指数、软骨损伤、年龄、移植物选择、受伤与手术之间的时间间隔这些因素会对创伤后膝骨关节炎的发展产生影响；②虽然前交叉韧带重建主要是恢复前交叉韧带断裂后的稳定性，该过程的一个长期目标是降低膝关节骨关节炎产生的风险，并维持关节长期处于健康状态；③患者前交叉韧带断裂后伴随半月板损伤需要进行半月板切除也是导致膝骨关节炎的原因，这很可能是由于关节的承受力减弱和关节运动学改变所致。ORCID: 0000-0001-9413-439X(韩广弢)中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程
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| 关 键 词： | 前交叉韧带损伤 创伤后膝骨关节炎 前交叉韧带重建 半月板状态 体质量指数 软骨损伤 年龄 移植物选择 受伤与手术之间的时间间隔 |
| 收稿时间： | 2019-10-24 |
Role and significance of anterior cruciate ligament injury in the development of post-traumatic knee osteoarthritis |
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| Han Guangtao,Li Haohuan,Gao Feng. Role and significance of anterior cruciate ligament injury in the development of post-traumatic knee osteoarthritis[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(15): 2440-2446. DOI: 10.3969/j.issn.2095-4344.2629 |
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| Authors: | Han Guangtao Li Haohuan Gao Feng |
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| Affiliation: | Departmentof Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, HubeiProvince, China |
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| Abstract: | BACKGROUND:Anterior cruciate ligament has the function of stabilizing the knee joint and restricting the tibiofemoral joint in the translation and rotation of the tibia.Most patients with anterior cruciate ligament reconstruction have an increased risk of knee pain and knee instability.Knee osteoarthritis after trauma is a serious complication of anterior cruciate ligament injury.Knee osteoarthritis is a chronic progressive disease,and the mechanism of osteoarthritis after anterior cruciate ligament injury remains unclear.OBJECTIVE:To review the relationship between anterior cruciate ligament injury and the risk factors of post-traumatic knee osteoarthritis,so as to provide guidance for the treatment of post-traumatic knee osteoarthritis.METHODS:The first author searched related articles in PubMed database from the establishment of the database to October 2019.The key words were“ACL injury,traumatic knee osteoarthritis,ACL reconstruction,meniscus status,body mass index,cartilage injury,age,graft selection,time interval between injury and surgery”.A total of 123 articles were retrieved,and 66 articles were eligible for the inclusion criteria.RESULTS AND CONCLUSION:(1)Meniscus status,body mass index,cartilage damage,age,graft selection,and time between injury and surgery may influence the development of post-traumatic knee osteoarthritis.(2)Although anterior cruciate ligament reconstruction is primarily performed to restore stability after anterior cruciate ligament rupture,a long-term goal of the process is to reduce the risk of knee osteoarthritis and maintain long-term joint health.(3)Meniscus resection in patients with anterior cruciate ligament rupture accompanied by meniscus injury is also the cause of knee osteoarthritis,which is likely to be caused by weakened endurance and kinematic changes of the joint. |
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| Keywords: | anterior cruciate ligament injury traumatic knee osteoarthritis anterior cruciate ligament reconstruction meniscus status body mass index cartilage injury age graft selection time interval between injury and surgery |
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