Yang Shun-Jie, Li Jian, Xue Yang, Chen Gang
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
Zhongguo Gu Shang. 2021 Dec 25;34(12):1114-20. doi: 10.12200/j.issn.1003-0034.2021.12.005.
To explore the influencing factors of the postoperative effect of arthroscopic treatment of symptomatic discoid lateral meniscus (DLM).
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 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.
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 (<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(<0.05). Ordinal logistic regression analysis showed that female was an independent risk factor for postoperative efficacy (=0.002, =0.370);body mass index (=0.007, =0.894), work intensity(=0.004, =0.525), age of operation(<0.001, =0.953), duration of symptoms(<0.001, =0.989), degree of cartilage damage (=0.016, OR=0.631) were negatively correlated with Lysholm knee function classification.
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.
探讨关节镜治疗症状性盘状外侧半月板（DLM）术后效果的影响因素。
回顾性分析2008年9月至2015年9月期间接受关节镜手术治疗的症状性DLM患者。采用Lysholm评分系统评估膝关节功能。根据评分结果分为优（≥90分）、良（80至89分）、可（70至79分）和差（<70分）。收集16个研究因素，即性别、手术年龄、体重指数、工作强度、症状持续时间、膝关节损伤史、患侧膝关节、DLM分类、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程度、Kellgren-Lawrence（K-L）分级、手术方式及末次随访时间。根据数据类型，采用Kruskal-Wallis秩和检验或t检验进行单因素分析，采用有序Logistic回归模型进行多因素分析。单因素分析显示有统计学意义的因素纳入多因素分析模型，得出影响症状性DLM疗效的独立危险因素。
根据纳入和排除标准，纳入502例患者。末次随访时Lysholm功能分级高于术前（<0.001）。单因素分析显示，Lysholm功能分级在性别、体重指数、工作强度、膝关节损伤史、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方面存在显著差异（<0.05）。有序Logistic回归分析显示，女性是术后疗效的独立危险因素（P=0.002，OR=0.370）；体重指数（P=0.007，OR=0.894）、工作强度（P=0.004，OR=0.525）、手术年龄（<0.001，OR=0.953）、症状持续时间（<0.001，OR=0.989）、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。
关节镜是治疗症状性DLM的一种安全有效的方法。性别、体重指数、工作强度、手术年龄、症状持续时间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。
