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吸烟对内侧半月板低血供区和无血供区修复术后结果无影响:一项初步研究。

Smoking Has No Influence on Outcomes after Repair of the Medial Meniscus in the Hypo and Avascular Zones-A Pilot Study.

机构信息

Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, University of Medical Sciences, 61-545 Poznan, Poland.

Department of Orthopaedics, Orvit Clinic, Citomed Healthcare Center, 87-100 Torun, Poland.

出版信息

Int J Environ Res Public Health. 2022 Dec 2;19(23):16127. doi: 10.3390/ijerph192316127.

Abstract

Complete loss of the meniscus inevitably leads to knee joint degeneration. Smoking is an important factor predicting poor outcome in orthopedics; however, data about its role in meniscus surgery are inconclusive. Smoking could be an important negative factor in isolated meniscus repair. The aim of this paper was to determine the influence of smoking on functional outcomes after isolated all-inside medial meniscus repair. This study included 50 consecutive patients with isolated, traumatic tear of the medial meniscus who underwent knee joint arthroscopy between 2016 and 2019. All-inside arthroscopic repair of the medial meniscus was performed in each case. All patients followed a uniform, postoperative rehabilitation protocol for 8 weeks. The follow-up examination was based on the functional scores at 3 and 6 months postoperatively. According to smoking status there were 17 smokers and 33 non-smokers. The mean number of cigarettes smoked per day was 11, for a mean of 7.4 years, and the mean pack-years index value was 4.9. There was no correlation between smoking years, number of cigarettes smoked per day, pack-years index, and functional outcomes. The arthroscopic inspection of the knee joints revealed cartilage lesions (≤IIº) in eight subjects, suggesting the secondary pathology to the meniscus tear. In this study, we found no evidence of an association between smoking indices and functional outcomes after all-inside repair of chronic medial meniscus tear. The nature of the chronic meniscal tear could be smoking-resistant owing to the poor blood supply to the sites in which these specific lesions occur.

摘要

半月板完全撕裂不可避免地会导致膝关节退化。吸烟是预测骨科预后不良的一个重要因素;然而,关于其在半月板手术中作用的数据尚无定论。吸烟可能是半月板修复术的一个重要负面因素。本文旨在确定吸烟对内侧半月板全内修复后功能结果的影响。本研究纳入了 2016 年至 2019 年间接受膝关节镜检查的 50 例连续内侧半月板孤立性、外伤性撕裂患者。所有患者均接受了内侧半月板全内关节镜修复术。所有患者均遵循 8 周统一的术后康复方案。随访检查基于术后 3 个月和 6 个月的功能评分。根据吸烟状况,有 17 名吸烟者和 33 名不吸烟者。每天吸烟的平均支数为 11 支,平均吸烟年限为 7.4 年,平均包年指数值为 4.9。吸烟年限、每天吸烟支数、包年指数与功能结果之间均无相关性。膝关节关节镜检查显示 8 例患者存在软骨病变(≤Ⅱ°),提示半月板撕裂的继发病理改变。在本研究中,我们没有发现吸烟指数与慢性内侧半月板撕裂全内修复后功能结果之间存在关联的证据。慢性半月板撕裂的性质可能是由于这些特定病变部位的血液供应较差而具有抗吸烟性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5661/9737454/2706672a3c86/ijerph-19-16127-g001.jpg

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