关节镜下ACL重建并半月板修复后半月板不愈合的危险因素分析  

Analysis of Risk Factors of Non-union of Meniscus after ACL Reconstruction Combined with Meniscus Repair

作　　者：王平 武春雷 许巍 张红 张弛 Wang Ping;Wu Chunlei;Xu Wei(Department of Orthopedics,983 Hospital of Joint Logistics Support Force,Tianjin 300142,China)

机构地区：[1]联勤保障部队第983医院骨科,天津300142

出　　处：《实用骨科杂志》2020年第9期782-786,共5页Journal of Practical Orthopaedics

摘　　要：目的探讨关节镜下前交叉韧带(anterior cruciate ligament,ACL)重建并半月板修复后半月板不愈合的危险因素。方法共纳入2017年5月至2018年6月于我院行关节镜下ACL重建并半月板修复的患者92例,术后随访18个月,6例失访,86例患者根据愈合情况分为愈合组(49例)和未愈合组(37例),手术愈合率为56.98%(49/86)。对比两组患者一般资料、手术情况等相关资料的差异,并行多因素logistic回归分析。结果两组身体质量指数(body mass index,BMI)、Tenger评分、受伤时间、ACL撕裂类型、半月板损伤区域比较差异具有统计学意义(P<0.05)。多因素logistic回归分析结果显示:BMI[OR=5.610,95%CI(1.447~21.759),P<0.05],Tenger评分[OR=4.237,95%CI(1.142~15.722),P<0.05],受伤时间[OR=5.280,95%CI(1.059~26.340),P<0.05],ACL撕裂类型[OR=9.517,95%CI(2.197~41.230),P<0.05],半月板损伤区域[OR=2.915,95%CI(1.201~7.073),P<0.05]是半月板不愈合的独立危险因素。结论BMI≥24kg/m2、复发性ACL撕裂、Tenger评分≥8分、受伤时间≥3个月、半月板损伤区域为非红区是关节镜下ACL重建并半月板修复后半月板不愈合的危险因素。Objective To investigate the risk factors of meniscus nonunion after anterior cruciate ligament(ACL)reconstruction and meniscus repair under arthroscopy.Methods A total of 92 patients who underwent arthroscopic ACL reconstruction and meniscus repair in our hospital from May 2017 to June 2018 were enrolled.They were followed up for 18 months after the operation.6 cases were lost to follow-up.86 patients were classified as healing according to the healing status.Group(49 cases)and non-healing group(37 cases),the surgical healing rate was 56.98%.The differences in general data,surgical conditions and other related data between the two groups of patients were compared,and multivariate logistic regression analysis was performed.Results There were significant differences in body mass index(BMI),Tenger score,injury time,ACL tear type,and meniscus injury area between the two groups(P<0.05).The results of multivariate logistic regression analysis showed:BMI[OR=5.610,95%CI(1.447~21.759),P<0.05],Tenger score[OR=4.237,95%CI(1.142~15.722),P<0.05],injury Time[OR=5.280,95%CI(1.059~26.340),P<0.05],ACL tear type[OR=9.517,95%CI(2.197~41.230),P<0.05],meniscus injury area[OR=2.915,95%CI(1.201~7.073),P<0.05]was an independent risk factor for meniscus nonunion.Conclusion BMI≥24 kg/m2,recurrent ACL tear,Tenger score≥8,injury time≥3 months,meniscus injury area is non-red area is the risk of meniscus nonhealing after arthroscopic ACL reconstruction and meniscus repair factor.

关 键 词：前交叉韧带重建 半月板修复 半月板不愈合 

分 类 号：R684[医药卫生—骨科学]