关节镜下半月板部分切除术术后效果的预测因素:回顾性分析

IF 1.8 2区 医学 Q2 ORTHOPEDICS
Orthopaedic Surgery Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI:10.1111/os.14218
Fan Lin, Lu Hengli, Kunpeng Zhu, Yuchen Bao, Jianfeng Pan
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引用次数: 0

摘要

目的:关节镜下半月板部分切除术是治疗半月板损伤的一种广泛应用的手术技术,但术后效果的个体差异仍是一个重要问题。这项回顾性研究旨在确定影响关节镜下半月板部分切除术后临床疗效的因素:我们回顾性研究了 2022 年 1 月至 5 月期间在我院接受关节镜下半月板部分切除术的 52 例患者的临床数据。系统记录了观察指标,包括性别、年龄、医疗保险类型、不同外科医生、住院费用中的自费部分以及住院总费用。随访期间,采用ΔTenger、ΔLysholm和国际膝关节文献委员会(IKDC)评分对主观症状进行评估。通过回归分析对上述问卷的趋势和潜在的预测因素进行了统计评估: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)和术前视觉模拟量表(VAS)较高(几率比 [OR]:3.58;95% 置信区间 [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)明显更有可能出现 FP IKDC 评分。多元线性回归分析显示,外伤性半月板撕裂(β = -0.324;95% CI:-0.948,-0.036;p = 0.035)是ΔTegner的负向独立预测因子,而术前VAS评分较高(β = 0.330;95% CI:0.013,0.217;p = 0.028)则被认为是ΔTegner的正向独立预测因子。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)等因素与 ΔIKDC 评分呈负相关:结论:该研究深入揭示了关节镜下半月板部分切除术后患者预后的多重因素。骨科医生需要考虑性别、体重指数、症状持续时间、术前 VAS 以及半月板撕裂的创伤/退行性类型等变量,以优化术后效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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

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

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.

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来源期刊
Orthopaedic Surgery
Orthopaedic Surgery ORTHOPEDICS-
CiteScore
3.40
自引率
14.30%
发文量
374
审稿时长
20 weeks
期刊介绍: Orthopaedic Surgery (OS) is the official journal of the Chinese Orthopaedic Association, focusing on all aspects of orthopaedic technique and surgery. The journal publishes peer-reviewed articles in the following categories: Original Articles, Clinical Articles, Review Articles, Guidelines, Editorials, Commentaries, Surgical Techniques, Case Reports and Meeting Reports.
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