影响关节镜下半月板切除术预后的多因素分析

目的评估年龄、性别、病程、手术侧别和范围五个因素对半月板切除术预后的影响。方法216例单纯一侧半月板损伤患者行关节镜下切除术,术后平均随访5.1（2.4-8.0）年。术后膝关节功能采用Lysholm-Ⅱ评分;X片骨关节炎程度用Fairbank标准分级,术后X片改变（ΔG）取手术前后X片分级的差值。先将五个因素对Lysholm-Ⅱ评分、ΔG作单因素分析,找出有影响的因素,再行Logistic回归分析,得出该因素对Lysholm-Ⅱ评分和ΔG的回归方程。结果病程与手术范围对术后Lysholm-Ⅱ评分和△G有显著影响。由回归方程推知病程越长、手术范围越大,Lysholm-Ⅱ评分等级低,△G改变大的概率越高。结论早期手术与最大限度保留正常半月板组织是保证半月板切除手术效果的关键。

Multivariate Analysis of the Factors Affecting the Prognosis of Arthroscopic Meniscectomy

Objective To evaluate the effects of five factors including age, gender, disease course, extent and location of meniseeetomy to the prognosis after arthroscopic meniscectomy. Methods 216 individuals who underwent unilateral arthroscopic meniseectomy were followed up in this study. The follow-up time ranged from 2.4 to 8.0 years, with a mean of 5.1 years. Lysholm-Ⅱ score was used to evaluate the knee joint function after surgery. Fairbank＇s criteria was used to evaluate the radiologieal changes （△G） indicating osteoarthritis of the knee. All the factors were analyzed by univariate analysis first. Then, the factors which appeared to affect the outcomes after meniscectomy, in univariate analysis were analyzed by multivariate analysis to get logistic equations. According to the equations, outcomes after meniscectomy could be forecasted. Results Disease course and extent of the meniscectomy showed significant association with outcomes of Lysholm- Ⅱ score and △G. The logistic equations indicated that it would be a high possibility of lower Lysholm- Ⅱ score and more obvious △G in the patients who had long disease course and larger extent of the meniscectomy. Conclusion It plays an important role of early operation and reservation the maximum normal meniscus in the good postoperative outcomes of arthroscopic menisectomy.