关节镜治疗早期膝骨关节炎疗效的影响因素分析

Factors Affecting the Outcome of Arthroscopy in Early Osteoarthritis of the Knee

目的分析影响关节镜治疗膝关节骨关节炎(osteoarthritis,OA)疗效的相关因素。方法本研究回顾性分析我院接受关节镜治疗的膝OA患者252例。记录各研究对象年龄、性别、症状持续时间、术前患膝站立位平片、Kellgren-Lawrence(K-L)分级、患膝绞锁症状、患膝压痛点、半月板破裂情况、游离体、手术前及术后1年膝关节Lysholm功能评分。采用多因素非条件Logistic回归分析影响疗效相关因素。结果高龄、症状持续时间长、K-L分级高、半月板破裂、关节腔存在游离体、绞锁症状及压痛点均与关节镜治疗OA的疗效差成正相关,且差异有统计学意义;而性别与疗效差异无统计学意义,且年龄、K-L分级、半月板破裂情况、存在绞锁症状及压痛点为影响其疗效的独立危险因素。结论高龄、K-L分级2级、无半月板破裂、无绞锁症状及无压痛点等均为影响疗效的独立危险因素。

Objective To achieve the related factors affecting arthroscopy（ debridement or microfracturing of chondral defects） in patients with osteoarthritis（ OA） of the knee. Methods Retrospective analysis was applied to research 252 patients according with the received criteria. Age,gender,trauma history,preoperative knee standing radiographs of Kellgren-Lawrence（ K-L grades） classification,mechanical locking,knee tenderness,meniscus rupture,loose body,preoprative and postoprative Lysholm score were recorded and analyzed. Multi-factor unconditioned Logistic regression analysis was applied to analyze the related factors. Results Except for gender,significant difference could be found in the analysis of all the other factors. According to the results of multi-factor analysis,age,K-L grades,meniscus rupture,mechanical lockingand knee tenderness were risk factors of no avail. Conclusion High incidence of poor efficacy was discovered in subjects of study with age less than 50 years old,K-L grade 2,mechanical locking symptom,meniscus degeneration or fixed tenderness point.