基于Kaplan-Meier的关节镜下髌骨脱位三联修复术远期效果评价

Kaplan-Meier analysis on the long-term effect for patients with patellar dislocation who underwent arthroscopy

目的使用Kaplan-Meier分析法评价关节镜下复发性髌骨脱位三联修复术远期效果。方法入选髌骨脱位患者69例髌骨脱位患者随机分为观察组(n=36)及对照组(n=33),分别给予关节镜下三联修复及普通双束解剖重建内侧髌股韧带治疗髌骨脱位。对以上患者进行为期5年的长期随访,比较手术前后外侧髌股角、Lysholm评分及疗效维持情况。结果治疗前两组外侧髌股角及Lysholm评分均无组间差异(P>0.05);末次随访时,两组患者的外侧髌股角及Lysholm评分均显著大于/高于手术前,观察组上述两者显著大于/高于对照组(P<0.05)。两组分别有3及4例患者删失,删失率无统计学差异(P>0.05)。两组最长疗效维持时间分别为75及68个月;观察组的疗效维持时间的算术均数及中位数分别为58及54个月,而对照组分别为48及42个月。Kaplan-Meier分析显示两组患者的累积疗效维持率差异具有统计学意义(χ2=3.481,P=0.032)。结论关节镜下复发性髌骨脱位三联修复术远期效果优于普通双束解剖重建内侧髌股韧带法。

Objective To make the Kaplan- Meier analysis evaluation under arthroscopy recurrent patellar dislocation（PD） the joint prosthesis of long-term outcome.Methods We selected 69 patients with PD PD patients were randomly divided into observation group（n=36） and control group（n=33）,were given under the arthroscope sanlian repair and ordinary double beam anatomic reconstruction of the medial patellofemoral ligament in the treatment of PD.For patients with more than 5 years of long-term follow-up,compared before and after operation of the lateral patellofemoral Angle,Lysholm scale effect and maintain.Results The two groups before treatment of the lateral patellofemoral Angle and Lysholm scale are no difference between groups（P0.05）; At the time of the last follow-up,two groups of patients of the lateral patellofemoral Angle and Lysholm score were significantly greater than/higher than before the operation,observation group had a significantly greater than/the above both higher than that of control group（P0.05）.Two groups there were 3 and 4 cases with delete,delete loss rate was no statistical difference（P0.05）.Two groups of curative effect to maintain time longest respectively in 75 and 68months; The curative effect of observation group of arithmetic mean and the median time of 58 and 54 months respectively,and the control group of 48 and 42 months respectively.Kaplan and Meier analysis showed that the cumulative effect of two groups of patients maintain rate differences statistically significant（χ~2=3.481,P=3.481）.Conclusion The joint prosthesis under arthroscopy recurrent patellar dislocation long-term effect is superior to the ordinary double beam anatomic reconstruction of the medial patellofemoral ligament method.