| 影响症状性外侧盘状半月板术后疗效的相关危险因素分析 |
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投稿时间：2021-01-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 杨顺杰 |
YANG Shun-jie |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 李箭 |
LI Jian |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 薛扬 |
XUE Yang |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 陈刚 |
CHEN Gang |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
drchengang@hotmail.com |
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| 期刊信息：《中国骨伤》2021年，第34卷，第12期，第1114-1120页 |
| DOI：10.12200/j.issn.1003-0034.2021.12.005 |
| 基金项目:成都市科技项目（编号：2021-YF05-00684-SN） |
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中文摘要:
目的：探讨关节镜治疗症状性外侧盘状半月板（discoid lateral meniscus，DLM）术后疗效的影响因素。
方法：回顾性分析2008年9月至2015年9月于四川大学华西医院运动医学中心诊断为症状性DLM并行关节镜手术治疗的患者。膝关节功能由Lysholm评分系统进行评估，根据评分结果分为优（≥ 90分）、良（80~89分）、可（70~79分）、差（<70分）。收集患者临床资料，包括性别、手术年龄、体质量指数、工作强度、症状持续时间、膝关节创伤史、受累膝关节侧别、DLM分型、DLM损伤类型、DLM损伤部位、内侧半月板损伤、膝关节软骨损伤部位及损伤程度、Kellgren-Lawrence （K-L）分级、手术方式、末次随访时间共16项拟研究因素。根据数据类型，单因素分析采用Kruskall-Wallis秩和检验或χ2检验，多因素分析采用有序Logistic回归模型。单因素分析具有统计学意义的因素纳入多因素分析模型，最终获得影响症状性DLM术后疗效的独立危险因素。
结果：根据纳入排除标准，共纳入502例患者。末次随访的Lysholm功能分级高于术前（P<0.001）。单因素分析显示：在Lysholm各功能分级之间，性别、体质量指数、工作强度、膝关节创伤史、手术年龄、症状持续时间、内侧半月板损伤、K-L分级、手术方式、膝关节软骨损伤部位及程度的差异均有统计学意义（P<0.05）。有序Logistic回归分析显示：女性是影响术后疗效的独立危险因素（P=0.002，OR=0.370）；体质量指数（P=0.007，OR=0.894），工作强度（P=0.004，OR=0.525），手术年龄（P<0.001，OR=0.953），症状持续时间（P<0.001，OR=0.989），膝关节软骨损伤程度（P=0.016，OR=0.631）与Lysholm膝关节功能分级呈负相关。
结论：关节镜是治疗症状性DLM安全、有效的方法，性别、体质量指数、工作强度、手术年龄、症状持续时间以及膝关节软骨损伤程度是症状性DLM术后疗效的独立影响因素。 |
| 【关键词】半月板 关节镜 治疗结果 危险因素 |
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| Risk factors for the postoperative effect of symptomatic discoid lateral meniscus after arthroscopy |
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ABSTRACT
Objective: To explore the influencing factors of the postoperative effect of arthroscopic treatment of symptomatic discoid lateral meniscus(DLM).
Methods: From September 2008 to September 2015,patients with symptomatic DLM treated by arthroscopic surgery were retrospectively analyzed. The knee function was evaluated by Lysholm scoring system. According to the scoring results,it was divided into excellent (≥ 90 points),good (80 to 89 points),fair (70 to 79 points) and poor(<70 points). Sixteen research factors were collected,namely gender,operation age,body mass index,work intensity,symptom duration,history of knee injury,involved knee side,DLM classification,DLM injury type,DLM injury site,medial meniscus injury,knee cartilage injury site and degree,Kellgren-Lawrence (K-L) classification,operation method,and latest follow-up time. According to the data type,Kruskall-Wallis rank sum test or χ2 test was used for univariate analysis,and ordinal Logistic regression model was used for multivariate analysis. Univariate analysis showed that the statistically significant factors were included in the multivariate analysis model,and the independent risk factors influencing the curative effect of symptomatic DLM were obtained.
Results: According to the inclusion and exclusion criteria,502 patients were included. Lysholm functional grade at the latest follow-up was higher than that before operation(P<0.001). Univariate analysis showed that there were significant differences in gender,body mass index,work intensity,history of knee injury,age of operation,duration of symptoms,medial meniscus injury,K-L grade,operation method,location and degree of knee cartilage injury among Lysholm functional grades(P<0.05). Ordinal logistic regression analysis showed that female was an independent risk factor for postoperative efficacy (P=0.002,OR=0.370);body mass index (P=0.007,OR=0.894),work intensity(P=0.004,OR=0.525),age of operation(P<0.001,OR=0.953),duration of symptoms(P<0.001,OR=0.989),degree of cartilage damage (P=0.016,OR=0.631) were negatively correlated with Lysholm knee function classification.
Conclusion: Arthroscopy is a safe and effective method for the treatment of symptomatic DLM. The gender,body mass index,work intensity,age of operation,duration of symptoms and degree of knee cartilage injury are independent influencing factors for the postoperative efficacy of symptomatic DLM. |
| KEY WORDS Meniscus Arthroscopes Treatment outcome Risk factors |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 杨顺杰,李箭,薛扬,陈刚.影响症状性外侧盘状半月板术后疗效的相关危险因素分析[J].中国骨伤,2021,34(12):1114~1120 |
| 英文格式: | YANG Shun-jie,LI Jian,XUE Yang,CHEN Gang.Risk factors for the postoperative effect of symptomatic discoid lateral meniscus after arthroscopy[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(12):1114~1120 |
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