摘要
背景:半月板部分切除可有效减少退行性内侧半月板后根撕裂患者的机械症状,但其不能阻止膝关节骨性关节炎的进展,可能与下肢力线对预后的影响相关。目的:探讨退行性内侧半月板后根撕裂患者行半月板部分切除后患侧膝关节骨关节炎进展与术前患侧膝关节髋膝踝角之间的相关性。方法:回顾性分析中国人民解放军联勤保障部队第904医院2014年1至12月退行性内侧半月板后根撕裂行半月板部分切除治疗患者的病历资料,共纳入患者138例,平均随访(5.53±0.58)年。以术前患肢髋膝踝角的最佳截断值将患者分为A组(髋膝踝角>176.2°,n=77)和B组(髋膝踝角≤176.2°,n=61)。行ROC曲线分析术前患肢髋膝踝角对术后美国特种外科医院评分HSS的预测价值,采用Spearman相关性分析探究术前患肢髋膝踝角与术后最终HSS值的相关性,比较两组术后患膝内侧关节间隙宽度与凯格伦-劳伦斯分级情况。试验获得联勤保障部队第904医院伦理委员会批准,批准号:2018-10-002。结果与结论:①ROC曲线显示,术前髋膝踝角对术后美国特种外科医院评分HSS具有一定的预测价值,曲线下面积为0.75;②单因素Logistics回归分析结果显示,术前髋膝踝角和术前病程是术后HSS评分的影响因素;多因素Logistics回归分析结果显示,术前髋膝踝角是HSS评分值的独立危险因素(P <0.01),体质量指数和术前病程均不影响髋膝踝角与HSS评分值之间的相关性;③Spearman相关性分析结果显示,术前髋膝踝角与术后HSS评分呈正相关(r=0.472,P <0.01),术前髋膝踝角越大,术后HSS评分越高、预后越好;④A组末次随访的关节间隙宽度大于B组(P <0.01),凯格伦-劳伦斯分级程度低于B组(P <0.05),说明A组的术后骨性关节炎进展慢于B组;⑤结果表明对于退行性内侧半月板后根撕裂患者,如果术前髋膝踝角≤176.2°则不适合进行半月板部分切除手术,如果术前髋膝踝�
BACKGROUND:Partial meniscecto my can effectively reduce the mechanical symptoms of degenerative medial meniscus poste rior root tear,but it cannot prevent the progression of knee osteoarthritis,which may be related to the effect of lower limb fo rce line on prognosis.OBJECTIVE:To investigate the correlation between the progression of knee osteoarthritis and the hip-knee-ankle angle in patients with degenerative medial meniscus posterior root tears after partial meniscectomy.METHODS:The medical reco rds of 138 patients with degenerative medial meniscus poste rior root tears treated by partial meniscectomy in 904 Hospital of the Joint Service Support Force of Chinese PLA from January to December 2014 were analyzed retrospectively.The average follow-up was(5.53±0.58)years.Patients were divided into group A(hip-knee-ankle angle>176.2°,n=77)and group B(hip-knee-ankle angle≤176.2°,n=61)acco rding to the best truncation value of hip-knee-ankle angle before operation.Receiver operator chara cteristic(ROC)curve was used to analyze the predictive value of preoperative hipknee-ankle angle to postoperative American special surgery hospital score HSS.Spearman correlation analysis was used to explore the correlation between preoperative hip-knee-ankle angle and postoperative final HSS value.The width of knee medial joint space and Kaglan-Lawrence classification were compared between the two groups.The trial was approved by the Ethics Committee of 904 Hospital of the Joint Service Support Force of Chinese PLA(approval No.2018-10-002).RESULTS AND CONCLUSION:(1)The ROC curve showed that the preoperative hip-knee-ankle angle had a certain predictive value to the postoperative American special surgery hospital score HSS,and the area under the curve was 0.75.(2)Univa riate Logistics regression analysis results showed that hip-kneeankle angle and preope rative course of disease were influencing facto rs for postoperative HSS score.Multiva riate Logistics regression analysis results showed that preoperative hip-knee-ankle angle w
作者
彭超
刘云鹏
华国军
杨家骥
王星亮
王小龙
Peng Chao;Liu Yunpeng;Hua Guojun;Yang Jiaji;Wang Xingliang;Wang Xiaolong(Anhui Medical University,Hefei 230000,Anhui Province,China;The 904 Hospital of the Joint Service Support Force of Chinese PLA,Wuxi 214000,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第21期3368-3373,共6页
Chinese Journal of Tissue Engineering Research
基金
无锡市科技发展资金项目(CSE31N1618),项目负责人:刘云鹏,项目名称:基于髌股关节三维运动模型的复发性髌骨脱位生物力学研究
无锡市卫生计生委科研项目(Q201772),项目负责人:王星亮,项目名称:内侧髌股韧带重建术对髌股关节解剖形态影响的影像学研究。
关键词
骨
半月板
退行性变
半月板后根撕裂
半月板部分切除
髋膝踝角
骨性关节炎
bone
meniscus
degeneration
meniscus posterior root tears
partial meniscectomy
hip-knee-ankle angle
osteoarthritis
