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术前血清钙水平可能是复发性髌骨脱位手术治疗的预后因素:一项回顾性研究。

Preoperative serum calcium could be a prognostic factor for surgical treatment of recurrent patellar dislocation: a retrospective study.

机构信息

Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.

出版信息

BMC Musculoskelet Disord. 2022 Jun 15;23(1):578. doi: 10.1186/s12891-022-05527-y.

Abstract

BACKGROUND

Surgical treatment for recurrent patellar dislocation (RPD) could yield good outcomes. While, unsatisfactory recovery still exists in some cases. For all prognostic factors, serum biomarkers have rarely been investigated. This study aimed to evaluate the prognostic value of preoperative serum calcium level, a widely used serum biomarker, in surgical treatment for RPD.

STUDY DESIGN

Retrospective study.

METHODS

Ninety-nine patients with RPD were enrolled in the study. Preoperative serum calcium was acquired from routinely tested blood 1 day prior to operation. Demographic data, characteristics of RPD, postoperative functional outcomes were obtained. The association between preoperative calcium and postoperative functional outcomes (Kujala, Lysholm, Tegner, IKDC and KOOS score) was determined by correlation analysis and multivariate linear regression analysis. Poor recovery was determined as Kujala score below 80. The receiver operating characteristic (ROC) curve was used to assess the prognostic value of preoperative calcium.

RESULTS

Patients were followed up for a mean period of 2.45 ± 1.33 years. All clinical scores showed significant improvement at the latest follow-up. Correlation and multivariate linear analyses indicated that serum calcium level was an important factor related with the prognosis of surgical treatment for RPD. According to the ROC curve, the cut-off value for preoperative calcium was 2.225 mmol/L. The clinical outcomes of patients with a preoperative blood calcium < 2.225 mmol/L was significantly worse than that with a higher calcium level. The correspondent sensitivity was 0.812 with a specificity of 0.633.

CONCLUSION

Operative treatment for RPD achieved good results, while in some cases the functional scores remain inferior. As a serum biomarker, preoperative calcium could be prognostic for outcomes after surgical treatment for RPD.

摘要

背景

对于复发性髌骨脱位(RPD)的手术治疗可以取得良好的效果。然而,在某些情况下,恢复仍不理想。在所有的预后因素中,血清生物标志物很少被研究过。本研究旨在评估术前血清钙水平(一种广泛使用的血清生物标志物)在 RPD 手术治疗中的预后价值。

研究设计

回顾性研究。

方法

本研究纳入了 99 例 RPD 患者。术前血清钙是在手术前 1 天常规检测血液中获得的。收集患者的人口统计学数据、RPD 特征和术后功能结果。通过相关分析和多元线性回归分析,确定术前钙与术后功能结果(Kujala、Lysholm、Tegner、IKDC 和 KOOS 评分)之间的关系。Kujala 评分低于 80 被确定为恢复不良。采用受试者工作特征(ROC)曲线评估术前钙的预后价值。

结果

患者平均随访 2.45±1.33 年。所有临床评分在末次随访时均有显著改善。相关性和多元线性分析表明,血清钙水平是与 RPD 手术治疗预后相关的重要因素。根据 ROC 曲线,术前钙的截断值为 2.225mmol/L。术前血钙<2.225mmol/L 的患者临床结果明显差于血钙水平较高的患者。对应的敏感性为 0.812,特异性为 0.633。

结论

手术治疗 RPD 效果良好,但在某些情况下功能评分仍不理想。作为一种血清生物标志物,术前钙可以预测 RPD 手术后的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7561/9199172/f2e4d2e099dd/12891_2022_5527_Fig1_HTML.jpg

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