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女性在半月板手术后 2 年的功能结果和生活质量均劣于男性:德国关节镜登记处的数据分析。

Females show worse functional outcome and quality of life compared to males 2 years after meniscus surgery: Data analysis from the German Arthroscopy Registry.

机构信息

Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany.

Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2024 Oct;32(10):2644-2654. doi: 10.1002/ksa.12131. Epub 2024 Mar 7.

Abstract

PURPOSE

The purpose of this study was to investigate the impact of sex on knee function, activity and quality of life following meniscus surgery using data from the German Arthroscopy Registry.

METHODS

This is a retrospective cohort study with data collected between 2017 and 2022. Patient-reported outcome measures (PROMs), namely Knee Injury and Osteoarthritis Outcome Score (KOOS), EuroQol Visual Analogue Scale (EQ Scale), and Marx Activity Rating Scale (MARS), were collected preoperatively and at 6, 12 and 24 months postoperatively. Data were analysed to examine differences between male and female patients regarding PROMs, pre-existing conditions, meniscus lesion types and surgical treatments.

RESULTS

A total of 1106 female (36.6%) and 1945 male patients (63.7%) were included. Males were significantly younger than females and had a higher body mass index. Overall, there were four times more medial meniscus lesions (MMLs) (77.5%) than lateral meniscus lesions (LMLs) (27.9%). Degenerative LMLs were more frequent in females, while traumatic LMLs were more common in males. Frequencies of traumatic and degenerative MMLs were similar among males and females. Males had higher absolute KOOS irrespective of treatment or meniscus lesion type. Meniscus repair resulted in similar improvements in ΔKOOS for both sexes, while meniscus resection exhibited higher absolute KOOS for males at each time point. Males generally had higher EQ Scale and MARS than females.

CONCLUSION

Greater improvements in knee function, activity and quality of life were observed in males. While MMLs appear to be comparable among sexes, the nature of LML differed significantly. These results may help surgeons to refine patient selection for specific treatments to improve overall clinical outcomes.

LEVEL OF EVIDENCE

Level III.

摘要

目的

本研究旨在利用德国关节镜登记处的数据,调查性别对半月板手术后膝关节功能、活动和生活质量的影响。

方法

这是一项回顾性队列研究,数据收集于 2017 年至 2022 年期间。收集了患者报告的结果测量(PROM),即膝关节损伤和骨关节炎结果评分(KOOS)、欧洲五维健康量表(EQ 量表)和 Marx 活动评分量表(MARS),分别在术前和术后 6、12 和 24 个月进行评估。分析数据以检查男女患者在 PROM、既往疾病、半月板病变类型和手术治疗方面的差异。

结果

共纳入 1106 名女性(36.6%)和 1945 名男性患者(63.7%)。男性明显比女性年轻,体重指数也更高。总体而言,内侧半月板病变(MML)的比例是外侧半月板病变(LML)的四倍(77.5%比 27.9%)。退行性 LML 在女性中更为常见,而外伤性 LML 在男性中更为常见。男女外伤性和退行性 MML 的发生率相似。无论治疗方法或半月板病变类型如何,男性的 KOOS 绝对值均较高。半月板修复在两种性别中均导致 KOOS 的相似改善,而半月板切除术在每个时间点均使男性的 KOOS 绝对值更高。男性的 EQ 量表和 MARS 一般高于女性。

结论

男性膝关节功能、活动和生活质量的改善更为显著。尽管 MML 在性别间似乎相似,但 LML 的性质却有明显差异。这些结果可能有助于外科医生针对特定治疗方法进行患者选择,以改善整体临床结果。

证据水平

III 级。

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