DefinePK

Research Objective

To evaluate articular cartilage after knee injuries in a young population as a predictor of early osteoarthritis, to enable more effective osteoarthritis preventive measures.

Methodology

Descriptive case series conducted in the Department of Orthopedics, Hayatabad Medical Complex, Peshawar, from 2020 to 2021. One hundred forty-five patients aged 18 to 50 years with a history of knee injuries were included. Patients with intra-articular fracture, malignant neoplasms, pathological fracture, and skeletal immaturity were excluded. Articular cartilage evaluation (chondral lesions and OA) was recorded using the ICRS grading system. Data analysis involved frequency, percentages, mean ±SD, and chi-square tests.

Methodology Flowchart

                        graph TD;
    A["Patient Recruitment 145 patients, age 18-50, knee injury history"] --> B["Exclusion Criteria Check"];
    B -- Excluded --> C["Discard"];
    B -- Included --> D["Informed Consent"];
    D --> E["Arthroscopic Evaluation ICRS Grading"];
    E --> F["Data Collection Chondral Lesions, OA"];
    F --> G["Data Entry SPSS 23"];
    G --> H["Statistical Analysis Frequency, Chi-square"];
    H --> I["Results Interpretation"];
    I --> J["Conclusion"];                    

Discussion

Acute and repetitive loading of joints in young individuals can damage joint surfaces, leading to progressive degeneration. Arthroscopic evaluation is a valuable tool for assessing knee articular cartilage damage and predicting early osteoarthritis in young populations. While arthroscopy is the gold standard, factors like magnification and the inherent difficulty in assessing lesion depth can be limitations.

Key Findings

The mean age of the patients was 32 years. A significant risk for early osteoarthritis was 17.9%. Females had a higher risk for early osteoarthritis compared to males (p=0.03). Age and grade of chondral lesion were significantly correlated with the risk for early osteoarthritis (p=0.00 and p=0.002, respectively). Significant risks for early osteoarthritis were 10.25% for anterior cruciate ligament tear, 23.08% for medial meniscus injury, and 15.38% for lateral meniscus injury. Concomitant meniscal and ACL injuries had a significant risk for early OA of 23.53%.

Conclusion

Arthroscopic evaluation of articular cartilage damage after knee injuries is a good predictor of early osteoarthritis in the young population. It is a safer, sensitive, and well-tolerated tool for evaluating patients with knee osteoarthritis compared to plain radiographs or MRI.

Fact Check

1. Mean Age: The study reports a mean age of 32 years for the 145 patients included.
2. Female Risk: The study found that females had a significantly higher risk for early osteoarthritis (37.03%) compared to males (13.56%) with a p-value of 0.00.
3. ACL Tear Risk: A significant risk for early osteoarthritis was reported as 10.25% for anterior cruciate ligament tears.

Mind Map