合并软骨损伤的前交叉韧带损伤特征的研究进展

Research Progress on Characteristics of Anterior Cruciate Ligament Injury with Cartilage Lesion

围绕合并软骨损伤的前交叉韧带(anterior cruciate ligament,ACL)损伤的流行病学特征、病理生理学特征、对前交叉韧带重建术(anterior cruciate ligament reconstruction,ACLR)术后疗效的影响以及治疗的选择4个方面进行综述。合并软骨损伤常引起ACLR后主观功能不良结果,影响患者重返运动,并发症如骨关节炎风险增高等,但仍存在一定争议且具体机制不明,有待进一步研究。对于已经合并软骨损伤患者,应根据病灶大小、分布、程度等因素,选择ACLR联合适当的软骨治疗技术。总结发现,联合手术技术可取得较为理想的软骨治疗效果,但现存外科技术在软骨再生方面本身具有局限性且可能对ACLR后疗效有负面影响。再生治疗展现出一定潜力,但尚需要进一步验证其对ACL联合软骨损伤的临床意义。未来研究可加深对联合损伤病理机制的探究,进一步为ACL损伤合并软骨损伤提供潜在治疗靶点及最佳治疗方案。

Epidemiological characteristics,pathophysiological characteristics,effects on the outcome of anterior cruciate ligament reconstruction(ACLR)and treatment options of anterior cruciate ligament(ACL)injury with cartilage lesion were reviewed as follows.Combined cartilage lesion often causes poor patient reported outcomes after ACLR,affecting patients’return to sports and increasing risk of complications such as osteoarthritis.However,there remains controversy and the specific mechanism is unknown and further research is needed.For patients with concomitant cartilage lesion,ACLR should be combined with appropriate cartilage treatment techniques according to size,distribution and the degree of lesion,etc.It is concluded that combined surgical technique can achieve ideal cartilage treatment results,but existing surgical technique has its own limitations in cartilage regeneration and may have a negative impact on the postoperative outcome of ACLR.Regenerative therapy has shown some potential,but its clinical significance for ACL-combined cartilage lesion needs to be further validated.Future research can further investigate the pathological mechanism of combined lesion and provide potential therapeutic targets and optimal treatment options for ACL injury with cartilage lesion.