Song Xiaoxiao, Chen Dongyang, Qi Xinsheng, Jiang Qing, Xia Caiwei
Department of Orthopedics, Affiliated Taikang Xianlin Drum Tower Hospital, Medical school of Nanjing University, Nanjing, Jiangsu, P.R. China.
Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, School of Medicine, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, PR China.
BMC Musculoskelet Disord. 2021 Mar 22;22(1):295. doi: 10.1186/s12891-021-04107-w.
Purpose To investigate the potential factors associated with the prevalence of meniscal repair Methods Patients who received partial meniscectomy or meniscal repair in our institution from Jan 2015 to Dec 2019 were included in current study. The inclusion criteria were (1) meniscus tear treated using meniscectomy or repair, (2) with or without concomitant anterior cruciate ligament reconstruction, (3) not multiligamentous injury. Demographic data, including sex, age, body mass index (BMI), injury-to-surgery interval and intra-articular factors such as the location of injury, medial or lateral, ACL rupture or not and the option of procedure (partial meniscectomy or repair) were documented from medical records. Univariate analysis consisted of chi-square. Multivariate logistic regression was then performed to adjust for confounding factors. Results 592 patients including 399 males and 193 females with a mean age of 28.7 years (range from 10 to 75 years) were included in current study. In the univariate analysis, male (p = 0.002), patients aged 40 years or younger (p < 0.001), increased weight (p = 0.010), Posterior meniscus torn (0.011), concurrent ACL ruputure (p < 0.001), lateral meniscus (p = 0.039) and early surgery (p < 0.001) were all associated with the prevalence of meniscal repair. However, After adjusting for confounding factors, we found that age (OR, 0.35; 95% CI, 0.17 - 0.68, p = 0.002), ACL injury (OR, 3.76; 95% CI, 1.97 - 7.21, p < 0.001), side of menisci (OR, 3.29; 95% CI, 1.43 - 7.55, p = 0.005), site of tear (OR, 0.15; 95% CI, 0.07 - 0.32, p < 0.001), and duration of injury (OR, 0.46; 95% CI, 0.28 - 0.82, p = 0.008) were associated with the prevalence of meniscus repair. Conclusions Meniscal tear in aged patients especially those with concomitant ACL injury is likely to be repaired. Additionally, in order to increase the prevalence of repair and slow down progression of OA, the surgical procedure should be performed within two weeks after meniscus tear especially when the tear is located at lateral meniscal posterior. STUDY DESIGN: Case-control study; level of evidence, 3.
目的 探讨与半月板修复患病率相关的潜在因素。方法 纳入2015年1月至2019年12月在我院接受部分半月板切除术或半月板修复术的患者。纳入标准为：（1）采用半月板切除术或修复术治疗的半月板撕裂；（2）伴或不伴有前交叉韧带重建；（3）非多韧带损伤。从病历中记录人口统计学数据，包括性别、年龄、体重指数（BMI）、受伤至手术间隔时间以及关节内因素，如损伤部位（内侧或外侧）、是否存在前交叉韧带断裂以及手术方式选择（部分半月板切除术或修复术）。单因素分析采用卡方检验。随后进行多因素逻辑回归以调整混杂因素。结果 本研究共纳入592例患者，其中男性399例，女性193例，平均年龄28.7岁（范围为10至75岁）。在单因素分析中，男性（p = 0.002）、40岁及以下患者（p < 0.001）、体重增加（p = 0.010）、后半月板撕裂（0.011）、同时存在前交叉韧带断裂（p < 0.001）、外侧半月板（p = 0.039）和早期手术（p < 0.001）均与半月板修复的患病率相关。然而，在调整混杂因素后，我们发现年龄（OR，0.35；95%CI，0.17 - 0.68，p = 0.002）、前交叉韧带损伤（OR，3.76；95%CI，1.97 - 7.21，p < 0.001）、半月板侧别（OR，3.29；95%CI，1.43 - 7.55，p = 0.005）、撕裂部位（OR，0.15；95%CI，0.07 - 0.32，p < 0.001）以及损伤持续时间（OR，0.46；95%CI，0.28 - 0.82，p = 0.008）与半月板修复的患病率相关。结论 老年患者尤其是伴有前交叉韧带损伤的半月板撕裂患者更有可能接受修复。此外，为了提高修复的患病率并减缓骨关节炎的进展，手术应在半月板撕裂后两周内进行，尤其是当撕裂位于外侧半月板后部时。研究设计：病例对照研究；证据级别：3级。
