Objective To analysis of the influence of different surgery timing on the knee arthroscopic treatment effect of anterior cruciate ligament (ACL) with meniscus injury.
Methods The clinical data of 86 patients with ACL associated with meniscus injury who underwent arthroscopic knee surgery were retrospectively analyzed. According to the different timing of arthroscopic knee surgery, they were divided into the early group (41 cases, the time from injury to surgery ≤3 weeks) and the late group (45 cases, the time from injury to surgery >3 weeks). Six months after operation, the recovery of bone channel, knee joint function, pain degree, stability stress, SDF-1/CXCR4 pathway-related factors in knee joint fluid and complications were compared between the two groups.
Results The signal intensity, bone marrow tract width and T2 value of tendon-bone junction in the early group were lower than those in the late group (P <0.01).The IKDC score, Lysholm score and knee joint range of the early group at six months after surgery were higher than those of the late group, and the VAS score was lower than that of the late group (P <0.01).In the early group, the distraction distance of the lateral compartment under stress, the posterior tibial distance under stress, and the dial-up tibial rotation angles of 30° and 90° of knee flexion were lower than those in the late group six months after surgery (P <0.01).The levels of SDF-1, CXCR4, MMP-3 and MMP-13 in knee joint fluid of the early group at six months after surgery were lower than those of the late group (P <0.01). The complication rate in the early group (4.88%) was lower than that in the late group (20.00%) (P <0.05).
Conclusions Compared with late arthroscopic knee surgery, early arthroscopic knee surgery can accelerate the recovery of bone channels, improve knee joint function and range of motion, reduce pain, improve stability stress, inhibit the expression of SDF-1/CXCR4 signal pathway, and then reduce the incidence of complications such as cartilage injury.
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