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关节镜下部分半月板切除术的术后结果预测因素:回顾性分析。

Predictors of Postoperative Outcomes after Arthroscopic Partial Meniscectomy: A Retrospective Analysis.

机构信息

Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Orthop Surg. 2024 Dec;16(12):2924-2932. doi: 10.1111/os.14218. Epub 2024 Sep 6.

Abstract

OBJECTIVE

Arthroscopic partial meniscectomy is a widely used surgical technique for treating meniscus injuries, while individual differences in postoperative outcomes remain a significant concern. This retrospective study aimed to identify the factors influencing clinical outcomes following arthroscopic partial meniscectomy.

METHODS

We retrospectively examined the clinical data of 52 patients who underwent arthroscopic partial meniscectomy at our institution from January to May 2022. Observation indicators, including gender, age, type of medical insurance, various surgeons, the self-pay portion of hospital costs, and total hospital costs, were systematically recorded. Subjective symptoms were evaluated with ΔTenger, ΔLysholm, and International Knee Documentation Committee (IKDC) scores during follow-up. The trends of the above questionnaires and potential predictors were statistically evaluated through regression analysis.

RESULTS

Binary logistic analysis revealed that female patients (OR: 32.42; 95% confidence interval [CI]: 2.22, 473.86) and higher preoperative visual analog scale (VAS) (odds ratio [OR]: 3.58; 95% CI: 1.55, 8.28) were significantly associated with FP Lysholm score. Similarly, patients with elevated preoperative VAS (OR: 1.47; 95% CI: 1.01, 2.15) were significantly more likely to have FP IKDC scores. Multiple linear regression analysis revealed that traumatic meniscus tear (β = -0.324; 95% CI: -0.948, -0.036; p = 0.035) emerged as a negative independent predictor of ΔTegner, while higher preoperative VAS scores (β = 0.330; 95% CI: 0.013, 0.217; p = 0.028) were identified as positive independent predictors of ΔTegner. The duration of symptoms (β = -0.327; 95% CI: -0.010, -0.001; p = 0.023) had a negative impact on the ΔLysholm scores. Factors such as body mass index (BMI) (β = -0.250; 95% CI: -1.000, -0.020; p = 0.042), duration of symptoms (β = -0.302; 95% CI: -0.009, -0.001; p = 0.014), and preoperative VAS (β = -0.332; 95% CI: -1.813, -0.250; p = 0.011) were negatively associated with ΔIKDC scores.

CONCLUSION

The study offers insights into multiple factors for patient outcomes after arthroscopic partial meniscectomy. Orthopedic surgeons need to consider variables such as gender, BMI, duration of symptoms, preoperative VAS, and the traumatic/degenerative types of meniscal tears to optimize postoperative outcomes.

摘要

目的

关节镜下半月板部分切除术是一种广泛应用于治疗半月板损伤的手术技术,而术后结果的个体差异仍然是一个重要的关注点。本回顾性研究旨在确定影响关节镜下半月板部分切除术术后临床结果的因素。

方法

我们回顾性地检查了 2022 年 1 月至 5 月在我院接受关节镜下半月板部分切除术的 52 名患者的临床数据。系统记录了观察指标,包括性别、年龄、医疗保险类型、不同的外科医生、医院费用的自付部分和总医院费用。在随访过程中,用 ΔTenger、ΔLysholm 和国际膝关节文献委员会(IKDC)评分评估主观症状。通过回归分析对上述问卷的趋势和潜在预测因素进行统计学评估。

结果

二元逻辑分析显示,女性患者(OR:32.42;95%置信区间[CI]:2.22,473.86)和较高的术前视觉模拟量表(VAS)(比值比[OR]:3.58;95%CI:1.55,8.28)与 FP Lysholm 评分显著相关。同样,术前 VAS 升高的患者(OR:1.47;95%CI:1.01,2.15)也更有可能获得 FP IKDC 评分。多线性回归分析显示,创伤性半月板撕裂(β=-0.324;95%CI:-0.948,-0.036;p=0.035)是 ΔTegner 的负独立预测因子,而较高的术前 VAS 评分(β=0.330;95%CI:0.013,0.217;p=0.028)是 ΔTegner 的正独立预测因子。症状持续时间(β=-0.327;95%CI:-0.010,-0.001;p=0.023)对 ΔLysholm 评分有负面影响。体重指数(BMI)(β=-0.250;95%CI:-1.000,-0.020;p=0.042)、症状持续时间(β=-0.302;95%CI:-0.009,-0.001;p=0.014)和术前 VAS(β=-0.332;95%CI:-1.813,-0.250;p=0.011)与 ΔIKDC 评分呈负相关。

结论

本研究深入探讨了关节镜下半月板部分切除术后患者结局的多种因素。骨科医生需要考虑性别、BMI、症状持续时间、术前 VAS 和半月板撕裂的创伤/退行性类型等变量,以优化术后结果。

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