关节镜治疗内侧半月板后根损伤后膝关节功能的关联因素分析及列线图预测模型构建  

Correlation factors of knee joint function and construction of a prediction model for posterior meniscal root injuries after arthroscopic surgery

作　　者：王华磊[1] 叶向阳[1] 马远[1] 程省[1] 王挺[1] Wang Hualei;Ye Xiangyang;Ma Yuan;Cheng Sheng;Wang Ting(Department of Orthopedics,Nanyang Central Hospital,Nanyang,Henan Province 473000,China)

机构地区：[1]南阳市中心医院骨科,河南南阳473000

出　　处：《创伤外科杂志》2024年第12期924-930,共7页Journal of Traumatic Surgery

基　　金：南阳市科技攻关计划项目(23KJGG094)。

摘　　要：目的分析关节镜治疗内侧半月板后根损伤后膝关节功能的关联因素并构建列线图预测模型。方法回顾性选取2019年1月—2023年9月南阳市中心医院骨科收治的内侧半月板后根损伤患者110例为研究对象。其中男性62例,女性48例;年龄22~73岁,平均50.4岁。术后7 d采用Lysholm膝关节功能评分表评估膝关节功能,按照得分情况分组,将0~60分的38例患者纳入功能不良组,61~100分的72例患者纳入功能良好组。分析膝关节功能不良的影响因素,构建列线图预测模型并验证价值。结果功能良好组在年龄、手术方式、BMI、术后并发症、定期专业康复训练、术后6个月VAS、Laprade分型与功能不良组比较差异有统计学意义(P<0.05);Logistic多因素回归分析显示,年龄>60岁、BMI≥24 kg/m^(2)、术后并发症、术后6个月VAS、Laprade分型为内侧半月板后根损伤患者关节镜治疗后膝关节功能不良的独立危险影响因素,定期专业康复训练为独立保护因素(P<0.05);列线图预测模型显示,曲线下面积(AUC)为0.861,95%CI:0.782~0.919,灵敏度为0.816,特异度为0.833,预测效能良好。结论年龄>60岁、BMI≥24 kg/m^(2)、术后并发症、术后疼痛评分、Laprade分型是影响内侧半月板后根损伤患者关节镜治疗后膝关节功能的重要危险因素,保护因素为定期专业康复训练。Objective To explore the correlation factors of knee joint function after arthroscopic surgery for posterior meniscal root injuries,and to construct a prediction model.Methods This retrospective study was conducted on 110 patients with posterior medial meniscus root tears admitted to our department from Jan.2019 to Sep.2023,including 62 males and 48 females aged from 22 to 73(mean 50.4)years.The knee joint function was assessed by Lysholm scores 7 d afteRsurgery,and patients with a score of 0-60 were classified into the poor function group and those with a score of 61-100 into the good function group.The correlation factors of knee joint dysfunction were analyzed,and a prediction model of nomogram was constructed and verified.Results Comparison between the two groups revealed significant differences in age,body mass index(BMI),Laprade classification,surgical scope,postoperative complications,regular and professional postoperative rehabilitation training,and VAS at postoperative 6 months(all P<0.05).Further multiple logistic regression analysis showed that age>60 years,BMI≥24 kg/m^(2),Laprade classification,postoperative complications and VAS at postoperative 6 months were independent risk factors for knee dysfunction in patients with posterioRmeniscal root injuries after arthroscopic treatment,whereas regular and professional rehabilitation training was an independent protective factor(P<0.05).A nomogram model was constructed and verified,with the area under the curve being 0.861,95%CI:0.782-0.919,sensitivity 0.816,and specificity 0.833.Conclusion Age>60 years,BMI≥24 kg/m^(2),Laprade classification,postoperative complications,and postoperative pain scores are important risk factors that affect knee joint function after arthroscopic treatment for patients with posterior medial meniscus root tears.Regular and professional rehabilitation training may prevent knee joint dysfunction in these patients.

关 键 词：半月板后根损伤 关节镜 膝关节功能 列线图模型 

分 类 号：R686[医药卫生—骨科学]