Rimtautas Gudas, Eimantas Spitrys
Knee articular cartilage lesions are a common and relevant problem. Lesions are influenced by gender, age, race, genetic factors, obesity, trauma, previous inflammatory processes. Modern methods of treatment of osteoarthritis can‘t fully restore degene rated cartilage normal function, so it is very important to assess risk factors and identify lesions of cartilage in time and choose the most effective treatment to stop further cartilage degeneration. This study shows the knee articular cartilage lesions dependence on key risk factors: age, gender, most vulnerable cartilage areas and the prevailing degree of lesions and their incidence in different age groups who had knee arthroscopic operations. Results. The study included 1145 patients who had knee joint arthroscopic operations during which were rated knee cartilage lesions degree and area according to the cartilage evaluation map and ICRS (International Cartilage Repair Society) form. The average age of studied patients was 45.97 ± 16.71. It was found that the knee articular cartilage defects were found in 65.0% of patients. No lesions were found in 35.0% of the patients. When men and women were compared according to whether lesions occur more frequently or which patient has more lesions p-value was calculated <0.05 and the Mann-Whitney average ratings show that lesions for women occurred more frequently. Knee articular cartilage I degree lesions were generally found 9.4% of all the lesions, II degree – 43.9%, III degree – 31.1%, IV degree – 15.6%. I degree lesions statistically significantly were more frequent for men p<0.05, II and III for women p<0.05, IV degree lesions statistically significant differences between gender were not found p>0.05. During arthroscopies 3770 lesions of different areas were found: men 37.3%, women 62.7%. Damaged areas distribution for both genders were: F1 2.9%, F2 1.4%, F3 13.6%, F4 13.4%, F5 5.6%, F6 5.4%, F7 0.2%, F8 0.3%, F9 2.1%, F10 2.0%, P1 2.3%, P2 2.4%, P3 8.9%, P4 9.0%, P5 1.9%, P6 1.9%, T1 3.0%, T2 0.5%, T3 1.0%, T4 8.1%, T5 7.5%, T6 0.3%, T7 0.1%, T8 0.0%, T9 3.1%, T10 3.1%. Patients were divided into seven age groups and it was found that for patients group under 25 years, various degree knee articular cartilage lesions were found in 28.5% of the knees and in 71.5% no lesions were found. For patients 25-35 years old lesions were found in 41.4% of the knees and in 58.6% cases no lesions were found. For patients 35-45 years old lesions were found in 57.9% of the knees and 42.1% no lesions were found. For patients 45-55 years old, lesions were found in 78.4% of the knees and 21.6% no lesions were found. For patients 55-65 years old lesions were found in 87.1% of the knees and 12.9% no lesions were found. For patients 65-75 years old lesions were found in 80.1% of the knees and 19.9% no lesions were found. For patients older than 75 years, lesions were found in 84.4% of the knees and 15.6% no lesions were found. For patients under 25 years I degree lesions were found in 29.6% of the cases, II degree – 56.8%, III degree – 7.4%, IV degree – 6.2%. For patients 25-35 years old, I degree lesions were found in 22.0% of the cases, II – 52.3%, III – 17.0% IV – 8.7%. For patients 35-45 years old, I degree lesions were found in 11.6% of the cases, II – 45.4%, III – 27.5% IV – 15.5%. For patients 45-55 years old, I degree lesions were found in 9.8% of the cases, II – 45.3%, III – 32.0% IV – 12.9%. For patients 55-65 years old, I degree lesions were found in 3.3% of cases, II – 44.4%, III – 37.9% IV – 14.4%. For patients 65-75 years old, I degree lesions were found in 6.9% of the cases, II – 36.0%, III – 33.8% IV – 23.3%. For older than 75 years patients I degree lesions were found in 3.9% of the cases, II – 30.5%, III – 35.1% IV – 30.5%. Spearman‘s rank correlation between the number of lesions of a particular patien t and the patient‘s age obtained p-value <0.05 shows that the correlation is statistically significant. Correlation 0.48 – strong, positive, showing that lesions were found in older people more frequently. Conclusions. Gender and age are a statistically significant factors for knee articular cartilage lesion degree and frequency. Age affects the size of the lesion degree, the older the patient the greater the degree of damage was determined in the articular cartilage of the knee. From 45-55 years significantly increases the knee articular cartilage lesions quantity and degree of lesions. The most commonly damaged areas of the knee articular cartilage were F3-F4 internal femoral condyle cartilage, P3-P4 patellar cartilage, T4-T5 internal tibial condyle cartilage.
Keyword(s): knee articular cartilage lesions; osteochondral defects; knee articular cartilage lesions dependence on age; most commonly damaged areas of knee articular cartilage; knee articular cartilage lesions dependence on gender.
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