膝骨关节炎内侧半月板挤出与下肢力线的相关性

Correlation of medial meniscus extrusion with lower limb alignment in knee osteoarthritis

[目的]探讨下肢力线参数与膝骨关节炎(knee osteoarthritis,KOA)患者内侧半月板挤出(meniscal medial extrusion,MME)程度的相关性。[方法]2022—2023年于本院接受治疗的KOA患者共307膝纳入本研究。采用单因素比较、Pearson相关分析分析MME与下肢力线的关系,采用ROC曲线评估下肢力线参数对MME程度的预测价值。[结果]以MRI测量MME结果,307膝分为两组,212膝MME>0.3 cm为重度组,占69.1%。95膝MME≤0.3 cm为轻度组,占30.9%。单因素分析显示,重度组的AMA[(6.9±1.0)°vs(5.9±0.8)°,P<0.001]、JLCA[(5.4±1.3)°vs(2.9±1.1)°,P<0.001]、mLDFA[(88.1±2.8)°vs(83.5±4.2)°,P<0.001]显著大于轻度组,而前者的MPTA[(86.1±3.0)°vs(86.6±3.1)°,P<0.001]、m HKA[(1.6±0.8)°vs(2.9±1.9)°,P<0.001]显著小于后者。两两相关分析表明:MME与AMA和JLCA、m LDFA呈显著正相关(P<0.05)。MME与FTA、MPTA、mHKA呈显著负相关(P<0.05)。ROC分析提示,AMA、JLCA、mLDFA值高于6.33°、3.55°、86.34°预测MME≥0.3 cm的曲线下面积(area under cuve,AUC)分别为0.807、0.954、0.791。[结论]AMA、JLCA及m LDFA与KOA患者的MME程度密切相关,可作为评估MME严重程度的重要参数。

[Objective]To investigate the correlation between lower limb alignment parameters and the extent of meniscal medial extru⁃sion(MME)in knee osteoarthritis(KOA).[Methods]A total of 307 patients with KOA treated in our hospital from 2022 to 2023 were in⁃cluded in this study.Univariate comparison and Pearson correlation analysis were used to analyze the relationship between MME and lower limb alignment,while ROC curve analysis was used to evaluate the predictive value of lower limb alignment parameters for MME degree.[Results]As results of MME measured on MRI,307 knees were divided into two groups.Of them,212 knees with MME>0.3 cm were marked as the severe group,accounting for 69.1%,while othor 95 knees with MME≤0.3 cm were as the mild group,accounting for 30.9%.In term of univariate comparison,the severe group proved significantly greater than the mild group regarding to AMA[(6.9±1.0)°vs(5.9±0.8),P<0.001],JLCA[(5.4±1.3)°vs(2.9±1.1)°,P<0.001],mLDFA[(88.1±2.8)°vs(83.5±4.2)°,P<0.001],while the former significantly less than the latter in MPTA[(86.1±3.0)°vs(86.6±3.1)°,P=0.005],mHKA[(1.6±0.8)°vs(2.9±1.9)°,P<0.001].In term of pairwise correlation,the MME was positively correlated with AMA,JLCA and mLDFA(P<0.05),while was significantly negatively correlated with FTA,MPTA and mHKA(P<0.05).ROC analysis indicated that AMA,JLCA and mLDFA with values higher than 6.33°,3.55°and 86.34°predicted MME≥0.3 cm got the area under cuve(AUC)of 0.807,0.954 and 0.791 respectively.[Conclusion]AMA,JLCA and mLDFA are closely re⁃lated to the degree of MME in KOA,and can be used as important parameters to evaluate the severity of MME.