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目的探讨军训及运动中膝关节稳定装置急慢性损伤的临床诊断与镜下诊断及其病理改变的差异程度。方法97例膝关节训练损伤患者通过关节镜观察进行诊断,分析急性及慢性膝关节损伤的诊断及病理改变差异程度。结果急性损伤(受伤6周之内)33例,临床诊断误诊率:ACL9.1%,PCL3.0%,半月板12.1%,二联征及三联征分别为6.1%及3.0%。慢性损伤64例,临床误诊率:ACL1.6%,半月板4.7%,二联征及三联征各为1.6%。急性损伤合并软骨退变损伤5例(15.2%),慢性损伤合并软骨退变性损伤25例(39.1%),其中慢性膝关节损伤中韧带损伤合并软骨损伤20例,占80.0%。结论急性膝关节损伤,由于关节肿胀、剧痛,临床检查受限,误诊率较高,应及早行关节镜检查,以提高诊断率。关节软骨损伤与关节损伤后不稳有关。慢性膝关节损伤引起软骨损伤的合并症,明显高于急性期,病程越长,软骨损伤越重。疑有韧带损伤、关节不稳、半月板损伤的患者应及早行韧带及半月板修复,以减少继发性软骨损伤。
Objective To explore the differences between the clinical diagnosis and microscopic diagnosis of the acute and chronic injury of the knee joint stability device in military training and exercise and its pathological changes. Methods Ninety-seven patients with knee joint injuries were diagnosed by arthroscopy. The differences of diagnosis and pathological changes between acute and chronic knee injuries were analyzed. Results 33 cases of acute injury (within 6 weeks after injury) were diagnosed as misdiagnosis rate of ACL9.1%, PCL3.0%, meniscus 12.1%, diplostosis and triad of 6.1% and 3.0% respectively. Chronic injury in 64 cases, clinical misdiagnosis rate: ACL1.6%, meniscus 4.7%, diarrhea and triadia were 1.6%. There were 5 cases (15.2%) of acute injury with cartilage degeneration and 25 cases (39.1%) of chronic injury with degeneration of cartilage. There were 20 cases of ligament injury and cartilage injury in 20% of chronic knee joint injury, accounting for 80.0%. Conclusions Acute knee injury, due to swollen and painful joints, limited clinical examination and high misdiagnosis rate, should be performed arthroscopy as soon as possible to improve the diagnosis rate. Articular cartilage injury and instability after joint injury related. Chronic knee injury caused by cartilage injury complications, was significantly higher than the acute phase, the longer the duration, the more serious cartilage damage. Suspected ligament injury, joint instability, meniscus injury patients should be as early as possible ligament and meniscus repair to reduce secondary cartilage injury.