影响富血小板血浆联合关节镜治疗III度半月板损伤膝关节功能恢复时间的因素分析

谭晋殿; 胡华明; 杨松; 林坚平; 吴巨峰

doi:10.12259/j.issn.2095-610X.S20230507

影响富血小板血浆联合关节镜治疗III度半月板损伤膝关节功能恢复时间的因素分析

doi: 10.12259/j.issn.2095-610X.S20230507

1.
海南省人民医院/海南医学院附属海南医院关节外科，海南海口　570311
2.
湖北省宜昌市第二人民医院骨外一科，湖北宜昌　443000
3.
海南省人民医院/海南医学院附属海南医院输血科，海南海口　570311

基金项目: 海南省卫生健康行业科研基金资助项目（20A200415）

详细信息

作者简介:
谭晋殿（1985～），男，海南海口人，医学硕士，主治医师，主要从事骨与关节疾病的诊断与治疗工作

通讯作者:
吴巨峰，E-mail：wujufeng2000@163.com

中图分类号: R684
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出版历程
- 收稿日期: 2023-01-25
- 网络出版日期: 2023-05-12
- 刊出日期: 2023-05-25

Analysis of Factors Affecting Knee Joint Function Recovery Time after Platelet-rich Plasma and Arthroscopy for III Degree Meniscus Injury

1.
）Dept. of Orthopaedic Surgery，Hainan General Hospital /Hainan Hospital Affiliated to Hainan Medical University，Haikou Hainan 570311
2.
Dept. of Orthopaedics，The 2nd People’s Hospital of Yichang，Yichang Hubei，443000
3.
Blood Transfusion Department of Hainan General Hospital /Hainan Hospital Affiliated to Hainan Medical University， Haikou Hainan 570311，China

摘要

摘要: 目的探究影响富血小板血浆联合关节镜治疗III度半月板损伤膝关节功能恢复时间的因素。方法将2020年10月1日至2022年8月20日在海南省人民医院骨科诊断为III度半月板损伤并行半月板成形手术并富血小板血浆的97例患者纳入研究，收集患者术前一般资料，包括性别、年龄、BMI；术前患者损伤情况，包括患肢（左/右）、半月板损伤部位（红区/红白交界区）。术后嘱患者进行功能锻炼，每天应用Lysholm 膝关节评分评价患膝功能，记录Lysholm 膝关节评分达到70分及以上的天数。并应用相关统计学方法分析影响患者术后膝关节功能恢复的因素。结果术后患者膝关节Lysholm评分到达70分的平均时间是（34.58±6.50）d。将性别、年龄、BMI、患膝部位（左/右）、半月板损伤部位（红区/红白交界区）因素纳入多因素COX比例风险模型，发现：年龄（HR = 0.953，95%CI = 0.925～0.982，P = 0.002），BMI（HR = 0.650，95%CI = 0.549～0.770，P < 0.001），相对于红区、红白交界区半月板损伤（HR = 0.463，95%CI = 0.296～0.726，P = 0.001）是影响术后膝关节功能恢复时间的重要因素。分层分析也证实了上述结果。结论 BMI和年龄是影响PRP联合关节镜治疗半月板损伤膝关节功能恢复时间的重要因素。
- 富血小板血浆 /
- 关节镜 /
- III度半月板损伤 /
- 膝关节 /
- 恢复时间
Abstract: Objective To investigate the factors affecting the knee joint function recovery time after the platelet-rich plasma and arthroscopy for III degree meniscus injury. Methods From October 1, 2020 to August 20, 2022, 97 patients diagnosed as III degree meniscus injury and treated with the meniscal plasty surgery and the platelet-rich plasma injection in the orthopedic department of Hainan province people’s hospital were recruited in this study. The data including gender, age, and BMI and the injury situation including the lesion limber （left/right）, and the concrete injured meniscus part （red zone and red and white junctional zone） before the operation were collected. After the operation, the patients were required to take the knee exercise for the lesion knee and the lesion knee function was evaluate with Lysholm knee function score. The time taken for the lesion knee function to arrive at 70 scores and above of Lysholm knee function score were recorded. Results The average time for the lesion knee function to arrive at 70 scores and above of Lysholm knee function score was 34.58±6.50 days. The data including gender, age, and BMI and the injury situation including the lesion limber （left/right）, and the concrete injured meniscus part （red zone and red and white junctional zone） were included into the multifactorial COX proportional hazards model, finding age （HR = 0.953, 95%CI = 0.925-0.982, P = 0.002）, BMI （HR = 0.650, 95%CI = 0.549-0.770, P < 0.001）, compared with red zone, red and white junctional zone （HR = 0.463, 95%CI = 0.296-0.726, P = 0.001） might be the important affecting the factors for knee function recovery after the operation, which also was proved by the hierarchical analysis of age and BMI. Conclusion Age and BMI might be the important affecting factors for knee function recovery after the platelet-rich plasma and arthroscopy treatment operation for III degree meniscus injury.
- Platelet rich plasm /
- Arthroscopy /
- III degree meniscus injury /
- Knee /
- Recovery time

HTML全文

图 1 Kaplan-Meier法分析患者恢复到Lysholm 膝关节评分70分的时间

Figure 1. The time of patients’ injured knee recovering to 70 scores of Lysholm knee score

下载: 全尺寸图片幻灯片

图 2 富血小板血浆联合关节镜治疗III度半月板损伤膝关节功能恢复的年龄、BMI因素的分层分析

^**P < 0.01。

Figure 2. The hierarchical analysis of age and BMI affecting knee joint function recovery after platelet-rich plasma and arthroscopy for III degree meniscus injury

下载: 全尺寸图片幻灯片

表 1 患者一般资料 [（$\bar x \pm s $）/n]

Table 1. The common resource of the included patients [（$\bar x \pm s $）/n]

项目	纳入样本（n = 97）
性别（男/女）	65/32
年龄（岁）	45.4 ± 8.8
BMI（kg/m²）	24.3 ± 1.5
患膝部位（左/右）	57/40
半月板损伤部位（红区/红白交界区）	63/34

下载: 导出CSV

表 2 影响富血小板血浆联合关节镜治疗III度半月板损伤膝关节功能恢复膝关节功能恢复的因素分析

Table 2. Analysis of factors affecting knee joint function recovery after platelet-rich plasma and arthroscopy for III degree meniscus injury

因素		单因素分析^a				多因素分析^b
因素		Beta	HR	95%CI	P	Beta	HR	95%CI	P
性别	女^Δ
	男	0.139	1.149	0.743~1.777	0.533	0.143	1.154	0.731~1.823	0.539
年龄（岁）		−0.062	0.940	0.915~0.965	< 0.001^**	−0.048	0.953	0.925~0.982	0.002^**
BMI （kg/m²）		−0.470	0.625	0.539~0.724	< 0.001^**	−0.431	0.650	0.549~0.770	< 0.001^**
患膝部位	右^Δ
	左	−0.090	0.914	0.602~1.388	0.673	0.075	1.078	0.700~1.658	0.734
半月板损伤部位	红白交界区^Δ
	红区	−0.502	0.606	0.398~0.922	0.019^*	−0.769	0.463	0.296~0.726	0.001^**
注：a：单因素COX风险比例模型；b：多因素COX风险比例模型，包括性别、年龄、BMI、患膝部位（左/右）、半月板损伤部位（红区/红白交界区）；Δ：参考变量；HR：Hazard rate，风险率；CI：Confidence interval，可信区间。^P < 0.05，^*P < 0.01。

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