半月板缝合术治疗膝关节半月板损伤的效果及对膝关节本体感觉、骨性标志物、关节滑液炎症因子的影响  

Effect of meniscus suture surgical on meniscus injury of knee and its influence on knee proprioception,bone markers and inflammatory factors in synovial fluid of knee joint

作　　者：焦李 杨书丰 计小鹏[2] JIAO Li;YANG Shu-feng;JI Xiao-peng(Department of Orthopedics,The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 210000,China;Department of Orthopedics and Traumatology,Pukou District Traditional Chinese Medicine Hospital Nanjing,Nanjing Jiangsu 210000,China)

机构地区：[1]南京医科大学第四附属医院骨科,江苏南京210000 [2]南京市浦口区中医院骨伤科,江苏南京210000

出　　处：《临床和实验医学杂志》2024年第20期2184-2188,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省社会发展面上项目(编号:BE2021071)。

摘　　要：目的前瞻性研究半月板缝合术治疗膝关节半月板损伤的效果及对膝关节本体感觉(KP)、骨性标志物、关节滑液炎症因子的影响。方法前瞻性选取2021年1月至2022年12月南京医科大学第四附属医院收治的膝关节半月板损伤患者104例为研究对象,按照随机数字表法将其分为试验组(n=52)和对照组(n=52)。试验组行半月板缝合术,对照组行关节镜半月板切除术(AM)。观察两组的围手术期指标,包括手术时间、术后功能锻炼开始时间及术后住院时间;术前及术后12个月膝关节功能;术后6周、6个月的KP情况;术前及术后6个月的血清骨钙素、骨碱性磷酸酶(BALP)、Ⅰ型前胶原羧基端肽(PⅠCP)等骨性标志物水平;术前及术后7 d的膝关节滑液肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-1β等炎症因子水平以及术后并发症发生情况。结果试验组的手术时间为(52.65±5.47)min,长于对照组[(47.27±4.98)min],试验组术后功能锻炼开始时间及术后住院时间分别为(3.26±0.34)、(8.96±0.92)d,均短于对照组[(4.16±0.43)、(11.53±1.32)d],差异均有统计学意义(P<0.05)。术后12个月,试验组Tegner评分、Lysholm评分分别为(7.29±0.74)、(88.29±8.95)分,均高于对照组[(6.87±0.70)、(82.90±8.42)分],差异均有统计学意义(P<0.05)。术后12个月,试验组15°、45°、75°等KP角度差值分别为(2.31±0.25)°、(2.18±0.22)°、(2.44±0.29)°,均小于对照组[(2.48±0.27)°、(2.33±0.24)°、(2.61±0.28)°],差异均有统计学意义(P<0.05)。术后6个月,试验组血清骨钙素、BALP、PⅠCP水平分别为(4.61±0.48)μg/L、(321.43±34.65)U/L、(158.07±17.28)μg/L,均大于对照组[(4.32±0.45)μg/L、(301.96±32.60)U/L、(147.13±15.86)μg/L],差异均有统计学意义(P>0.05)。术后7 d,试验组膝关节滑液TNF-α、IL-6、IL-1β水平分别为(5.74±0.59)pg/mL、(5.21±0.54)ng/mL、(0.15±0.02)pg/mL,均低于对照组[(6.13±0.62)pg/mL、(5.55±0.60)ng/mL、(0.17±0.0Objective To prospectively investigate the effect of meniscus suture surgical on meniscus injury of knee and its effects influence on knee proprioception(KP),bone markers and inflammatory factors in synovial fluid of knee joint.Methods A total of 104 meniscus injury of knee patients admitted to the Fourth Affiliated Hospital of Nanjing Medical University from January 2021 to December 2022 were prospective selected and randomly divided into the experimental group(n=52)and the control group(n=52)according to the random number table method.The experimental group underwent meniscus suture surgical,while the control group underwent arthroscopic meniscectomy(AM).The perioperative indexes such as operation time,start time of functional exercise and postoperative hospital stay,functional recovery of knee joint before operation,12 months after operation,KP at 6 weeks and 6 months after operation,serum osteocalcin,bone alkaline phosphatase(BALP),typeⅠprocollagen carboxy-terminal peptide(PⅠCP)and other bone markers before operation and 6 months after operation,the levels of inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin(IL)-6 and IL-1βin synovial fluid of knee joint before and 7 d after operation,postoperative complications were observed.Results The operation time of experimental group was(52.65±5.47)min,which was longer than that of control group[(47.27±4.98)min],the start time of functional exercise and postoperative hospital stay of the experimental group were(3.26±0.34)and(8.96±0.92)d,respectively,which were shorter than those of the control group[(4.16±0.43)and(11.53±1.32)d],the differences were statistically significant(P<0.05).At 12 months after operation,the Tegner score and Lysholm score of the experimental group were(7.29±0.74)and(88.29±8.95)scores,respectively,which were higher than those of the control group[(6.87±0.70)and(82.90±8.42)scores],the differences were statistically significant(P<0.05).At 12 months after operation,the differences of proprioceptive angle of knee

关 键 词：半月板 胫骨 半月板缝合术 膝关节半月板损伤 膝关节本体感觉 骨性标志物 关节滑液炎症因子 

分 类 号：R687.4[医药卫生—骨科学]