胫骨平台骨折术后膝关节功能的相关影响因素

Related influencing factors of knee joint function after tibial plateau fracture

目的分析胫骨平台骨折术后膝关节功能的相关影响因素。方法关节镜下微创手术治疗118例胫骨平台骨折患者,采用HSS评分评估膝关节功能,多元线性回归分析胫骨平台骨折术后膝关节功能影响因素,Spearman法分析术后膝关节功能与骨关节炎发生率及严重程度的关系。结果单因素分析显示,不同年龄、体重指数、骨折Schatzker分型、术前膝关节屈伸范围、术后并发症、伸膝装置损伤、胫骨平台后倾角、骨折复位质量的患者术后6个月HSS评分比较差异均有统计学意义(P<0.05)。多因素分析显示,超重、Schatzker分型Ⅲ~Ⅳ型、术前膝关节屈伸范围≥90°、伸膝装置损伤、胫骨平台后倾角>7°、年龄≥60岁、术后有并发症、骨折复位质量欠佳是影响胫骨平台骨折术后膝关节功能的危险因素(P<0.05)。骨关节炎发生率及WOMAC评分HSS评分≥70分患者均低于HSS评分<70分患者(P<0.05)。相关性分析显示,胫骨平台骨折术后膝关节功能HSS评分与骨关节炎发生率及严重程度均呈负相关(P<0.001)。结论超重、Schatzker分型Ⅲ~Ⅳ型、术前膝关节屈伸范围≥90°、伸膝装置损伤、术后胫骨平台后倾角>7°、年龄≥60岁、术后有并发症、骨折复位质量欠佳是影响胫骨平台骨折术后膝关节功能的危险因素,可制定针对性干预措施促进膝关节功能恢复,降低骨关节炎发生风险。

Objective To analyze the related influencing factors of knee joint function in patients with tibial plateau fracture after surgery.Methods The 118 patients with tibial plateau fractures were treated with minimally invasive surgery under arthroscopy.HSS score was used to evaluate knee joint function.Multiple linear regression was used to analyze the influencing factors of knee joint function in patients with tibial plateau fracture after surgery.Spearman method was used to analyze the relationship between postoperative knee function and the incidence rate and severity degree of osteoarthritis Results Univariate analysis showed that there were statistically significant differences in HSS scores at 6 months after surgery among patients with different age,body mass index,Schatzker fracture classification,preoperative knee flexion-extension range,postoperative complications,knee extension device injury,tibial plateau posterior slope and fracture reduction quality(P<0.05).Multivariate analysis showed that overweight,Schatzker typeⅢ~Ⅳ,preoperative knee flexion-extension range≥90°,knee extension device injury,tibial plateau posterior slope>7°,age≥60 years,postoperative complications,and poor fracture reduction quality were the risk factors for knee function after tibial plateau fracture(P<0.05).The incidence rate of osteoarthritis and WOMAC:HSS score≥70 points were lower than those with HSS score<70 points(P<0.05).Correlation analysis showed that HSS score of knee function after tibial plateau fracture was negatively correlated with the incidence and severity of osteoarthritis(P<0.001).Conclusions Overweight,Schatzker typeⅢ~Ⅳ,preoperative knee flexion-extension range≥90°,knee extension device injury,tibial plateau posterior slope>7°,age≥60 years,postoperative complications and poor fracture reduction quality are risk factors for knee function after tibial plateau fracture.Targeted intervention measures can be developed to promote knee function recovery and reduces the risk of osteoarthritis.