膝关节盘状半月板损伤患者关节镜术后疼痛对膝关节功能的影响及其危险因素的Logistic回归分析

Obser vation of the Medium-term Effect of Arthroscopic Application of FasT-Fix Stapler in Repair of Meniscus Injury and Analysis of Its Influencing Factors

目的探讨膝关节盘状半月板损伤患者关节镜术后疼痛对膝关节功能的影响及其危险因素。方法选择2018年5月至2021年11月我院膝关节盘状半月板损伤患者83例,均行关节镜手术。评估治疗效果、术前及术后1个月、3个月膝关节国际通用评分(IKDC)、Lysholm评分变化。疗效差、可纳入疼痛组,优、良纳入无痛组,比较两组术后3个月IKDC评分、Lysholm评分,Logistic回归分析疼痛的影响因素。结果关节镜手术治疗膝关节盘状半月板损伤总优良率为90.36%;术后1个月、3个月患者Lysholm评分、IKDC评分呈明显升高趋势(P<0.05);术后3个月疼痛组Lysholm评分、IKDC评分低于无痛组(P<0.05);疼痛组病程>1年、体质量指数(BMI)≥24kg/m^(2)、混合性撕裂、术后未行肢体冷敷、滑膜切除、开始负重时间<6周比例高于无痛组(P<0.05);Logistic回归分析,病程、BMI、混合性撕裂、术后肢体冷敷、滑膜切除、开始负重时间与其术后疼痛有关(P<0.05)。结论关节镜手术治疗膝关节盘状半月板损伤效果良好,能显著改善膝关节功能,但其术后疼痛可一定程度影响膝关节功能恢复;术后疼痛危险因素包括病程长、BMI大、混合性撕裂、未行肢体冷敷、滑膜切除、过早开始负重,临床可根据其高危因素施以针对性干预,减轻疼痛,促进康复,达到理想治疗效果。

Objective To investigate the effect of postoperative pain on knee joint function and its risk factors in patients with discoid meniscus injury of the knee joint.Methods A total of 83 patients with discoid meniscus injury in our hospital from May 2018 to November 2021 were selected and all underwent arthroscopic surgery.The treatment effect,the changes of the International Knee Joint Score(IKDC)and Lysholm score before and 1 month and 3 months after the operation were evaluated.The patients with poor curative effect could be included in the pain group,and those with excellent and good results were included in the painless group.The IKDC score and Lysholm score were compared between the two groups at 3 months after operation,and the influencing factors of pain were analyzed by Logistic regression.Results The overall excellent and good rate of arthroscopic surgery for discoid meniscus injury of the knee joint was 90.36%;the Lysholm score and IKDC score of the patients at 1 month and 3 months after operation showed a significant upward trend(P<0.05);3 months after operation The Lysholm score and IKDC score of the pain group were lower than those of the painless group(P<0.05).Membrane excision,time to start weight-bearing<6 weeks was higher than that of painless group(P<0.05);Logistic regression analysis,disease duration,BMI,mixed tear,postoperative limb cold compress,synovectomy,time to start weight-bearing and postoperative pain related(P<0.05).Conclusion Arthroscopic surgery has a good effect in the treatment of knee discoid meniscus injury and can significantly improve knee joint function,but postoperative pain can affect the recovery of knee joint function to a certain extent.Risk factors for postoperative pain include long course of disease,high BMI,mixed For tearing,limb cold compress,synovectomy,and premature weight-bearing,targeted interventions can be implemented according to their high-risk factors to reduce pain,promote recovery,and achieve ideal therapeutic effects.