| 半月板内突指数和内侧胫股关节软骨损伤程度的相关性研究 |
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Received:October 25, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 袁斌 |
YUAN Bin |
新沂市人民医院骨科, 江苏 徐州 221400 |
Department of Orthopedics, Xinyi People's Hospital, Xuzhou 221400, Jiangsu, China |
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| 张伟 |
ZHANG Wei |
新沂市人民医院骨科, 江苏 徐州 221400 |
Department of Orthopedics, Xinyi People's Hospital, Xuzhou 221400, Jiangsu, China |
15252017326@163.com |
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| 期刊信息：《中国骨伤》2023年36卷，第10期，第965-969页 |
| DOI：10.12200/j.issn.1003-0034.2023.10.011 |
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目的:探讨40~60岁怀疑或伴膝骨关节炎患者在非负重位下内侧半月板内突指数(medial meniscus displacement index,MDI)与内侧胫股关节软骨3度以上损伤的相关性和具有预测意义的临界值。
方法:收集2016年6月至2020年6月因膝关节慢性疼痛而行初次膝关节镜探查术的患者共308例,年龄36~71(56.40±1.82)岁,男105例,女203例。排除关节外畸形(力线异常)、外伤史、炎症性关节炎及其他特异性关节炎的患者,最终获得符合条件患者89例,年龄42~60(59.50±0.71)岁,其中男45例,女44例。记录膝关节内侧间室软骨损伤程度,根据Outer-Bridge分级,将软骨损伤程度分为2组, ≥ 3度组和<3度组。将两组患者的年龄、性别、侧别、身体质量指数(body mass index,BMI)、滑膜厚度评级、是否半月板损伤以及MDI进行单因素分析得出可能的危险因素,进一步实施二元Logistic回归分析得出3度以上软骨损伤的独立危险因素。若MDI作为独立危险因素,对其进行受试者工作特征(receiver operating characteristic,ROC)曲线分析,确认其是否对超过3度的软骨损伤具有诊断价值并计算出MDI临界值。
结果:共获得符合条件的患者89例,经过单因素分析结果显示年龄、BMI、MDI以及是否合并半月板损伤可能是3度以上软骨损伤的独立危险因素,带入二元Logistic回归分析模型最终得出MDI[OR=1.66,95%CI(1.64,1.69),P=0.01]和BMI[OR=1.58,95%CI(1.17,2.15),P=0.03]是纳入研究患者出现3度以上软骨损伤的独立危险因素;进一步ROC曲线分析显示MDI较BMI更具诊断价值,测得的MDI临界值为0.355,敏感度为89.1%,特异性为88.2%。
结论:在怀疑或伴有膝骨关节炎症状的40~60岁患者中,非负重位膝关节MRI检查测得的MDI对于内侧胫股关节 ≥ 3度的软骨损伤具有预测价值,其诊断3度以上软骨损伤的临界值为0.355。 |
| [关键词]:半月板 骨关节炎 关节镜 |
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| Analysis of the correlation between media meniscus displacement index and medial tibiofemoral articular cartilage damage |
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Abstract:
Objective To investigate the correlation between the medial meniscal indentation index (MDI) and medial tibiofemoral articular cartilage damage more than 3 degrees in patients aged 40 to 60 years old with suspected or complicated knee osteoarthritis at non-weight-bearing position,and to determine the predictive threshold.
Methods From June 2016 to June 2020,a total of 308 patients who underwent initial knee arthroscopic exploration for chronic knee pain were collected. The age ranged from 36 to 71 years old with an average of(56.40±1.82) years old,including 105 males and 203 females. And patients with extra-articular malformations (abnormal force lines),a history of trauma,inflammatory arthritis and other specific arthritis were excluded. Finally,89 eligible cases were obtained,aged from 42 to 60 years old with an average of (59.50±0.71) years old,including 45 males and 44 females. The degree of cartilage damage in the medial compartment of the knee joint was recorded,which was divided into two groups(≥ degree 3 and
Results A total of 89 eligible patients were obtained. Univariate analysis showed age,BMI,MDI and meniscus injury may be the independent risk factors for cartilage damage of more than 3 degrees,further binary Logistic regression analysis confirmed that MDI[OR=1.66,95%CI(1.64,1.69),P=0.01]and BMI[OR=1.58,95%CI(1.17,2.15),P=0.03] were independent risk factors for cartilage injury of more than degree 3 in enrolled patients. ROC analysis showed that MDI had more diagnostic value than BMI,and the critical value was 0.355 with a sensitivity of 89.1% and a specificity of 88.2%.
Conclusion In doubt or accompanied by 40 to 60 years old patients with knee osteoarthritis,the MDI measured by non-weight-bearing knee MRI has predictive value for cartilage injury of more than degree 3 in medial tibiofemoral joint,and the critical value for diagnosis of cartilage injury of more than degree 3 is 0.355. |
| KEYWORDS:Meniscus Osteoarthritis Joint arthroscopy |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 袁斌,张伟.半月板内突指数和内侧胫股关节软骨损伤程度的相关性研究[J].中国骨伤,2023,36(10):965~969 |
| 英文格式: | YUAN Bin,ZHANG Wei.Analysis of the correlation between media meniscus displacement index and medial tibiofemoral articular cartilage damage[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(10):965~969 |
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