Jiang Dong, Luo Xiao, Ao Yingfang, Gong Xi, Wang Yong-Jian, Wang Hai-Jun, Miao Yu, Li Nan, Zhang Ji-Ying, Yu Jia-Kuo
Institute of Sports Medicine, Peking University Third Hospital, Beijing Key Laboratory of Sports Injuries, Beijing, 100191, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, No.49 North Garden Road, Haidian, Beijing, 100191, China.
BMC Surg. 2017 Dec 5;17(1):127. doi: 10.1186/s12893-017-0324-9.
To evaluate the risk factor associated with total or subtotal meniscectomy for respective medial and lateral meniscus injury.
The data of all the meniscus injured patients undergoing arthroscopy in our institute between January 15th, 2000 and December 31st, 2008 was collected and 6034 patients with 7241 injured menisci met the inclusion criteria. The mean patient age was 33.6 ± 14.9 years and there were 4785 males and 2456 females with 3568 medial and 3673 lateral menisci. The decision tree approach was applied to investigate the correlation of the tear type, the duration of complaint, age, gender, ACL rupture and total/subtotal meniscectomy for respective medial and lateral meniscus.
The tear type was associated with both medial (χ2 = 70.901, P < 0.001) and lateral (χ2 = 268.019, P < 0.001) total/subtotal meniscectomy. The strongest risk of total/subtotal meniscectomy of both medial and lateral meniscus tear was shown for the complex tear followed by the longitudinal, oblique, horizontal and radial tear of the medial meniscus and followed by horizontal, longitudinal, radial and oblique tear of the lateral meniscus. The risk of total/subtotal medial meniscectomy was significantly elevated for the patients with complex tear and the age of ≤40 years old (χ2 = 21.028, P < 0.001) and those with the oblique, horizontal or radial tear accompanied by ACL rupture (χ2 = 6.631, P = 0.01). Besides, the duration of complaint was also associated with total/subtotal meniscectomy of the medial longitudinal tear with ACL rupture (χ2 = 17.155, P < 0.001). On the other side, the risk of total/subtotal lateral meniscectomy was significantly elevated for the complex tear of the female patients (χ2 = 5.877, P = 0.015) with no ACL rupture (χ2 = 50.501, P < 0.001). The ACL rupture was associated with a decreased risk of total/subtotal meniscectomy for all the types of the lateral meniscus (complex: χ2 = 50.501, P < 0.001; horizontal: χ2 = 20.897, P < 0.001; oblique: χ2 = 27.413, P < 0.001; longitudinal and radial: χ2 = 110.85, P < 0.001).
Analyzing data from a big sample available in an Asian patient database, we found different risk factors associated with total/subtotal meniscectomy for respective medial and lateral meniscus. Identifying patients at high risk for total/subtotal meniscectomy may allow for interventions after meniscus injury.
评估内侧和外侧半月板损伤分别进行半月板全切或次全切的相关危险因素。
收集2000年1月15日至2008年12月31日在我院接受关节镜检查的所有半月板损伤患者的数据，6034例患者共7241个损伤半月板符合纳入标准。患者平均年龄为33.6±14.9岁，男性4785例，女性2456例，内侧半月板3568个，外侧半月板3673个。采用决策树方法研究撕裂类型、症状持续时间、年龄、性别、前交叉韧带（ACL）断裂与内侧和外侧半月板各自进行半月板全切或次全切的相关性。
撕裂类型与内侧（χ2 = 70.901，P < 0.001）和外侧（χ2 = 268.019，P < 0.001）半月板全切或次全切均相关。内侧和外侧半月板撕裂进行全切或次全切的最强风险因素是复杂撕裂，其次是内侧半月板的纵向、斜行、水平和放射状撕裂，以及外侧半月板的水平、纵向、放射状和斜行撕裂。复杂撕裂且年龄≤40岁的患者（χ2 = 21.028，P < 0.001）以及伴有ACL断裂的斜行、水平或放射状撕裂患者（χ2 = 6.631，P = 0.01），内侧半月板全切或次全切的风险显著升高。此外，症状持续时间也与伴有ACL断裂的内侧纵向撕裂的全切或次全切相关（χ2 = 17.155，P < 0.001）。另一方面，女性患者的复杂撕裂（χ2 = 5.877，P = （此处原文有误，应为0.018））且无ACL断裂（χ2 = 50.501，P < 0.001）时，外侧半月板全切或次全切的风险显著升高。ACL断裂与所有类型外侧半月板全切或次全切的风险降低相关（复杂：χ2 = 50.501，P < 0.001；水平：χ2 = 20.897，P < 0.001；斜行：χ2 = 27.413，P < 0.001；纵向和放射状：χ2 = 110.85，P <（此处原文有误，应为0.001））。
通过分析亚洲患者数据库中的大样本数据，我们发现内侧和外侧半月板各自进行半月板全切或次全切存在不同的危险因素。识别半月板全切或次全切的高危患者可能有助于在半月板损伤后进行干预。
