内侧半月板突出(MME)及软骨损伤对内侧开放胫骨高位截骨术临床效果的影响

Medial Mensical Extrusion (MME) and Cartilage Injury on the Clinical Outcome after Medial Opening Wedge High Tibial Osteotomy (MOWHTO)

摘要: 目的：探讨内侧半月板突出(MME)及软骨损伤对因膝关节内侧间室骨性关节炎患者行内侧开放胫骨高位截骨术(MOWHTO)术后临床效果的影响。方法：回顾性分析于青医附院运动医学科因膝关节内侧间室骨性关节炎行内侧开放胫骨高位截骨术的患者，于术前及术后1个月、3个月、1年进行随访并于末次随访进行评分及影像学检查，分析MOWHTO的影响因素。结果：术前HKA (P < 0.05)、半月板损伤评分(P < 0.05)、BMI (P < 0.05)、K-L分级(P < 0.05)与MME严重程度有关系。将患者根据MME相对值分为4组，各组间术后1年时HSS评分有差异(P < 0.05)，将术后1年HSS评分作为因变量行多因素回归显示，软骨损伤评分、MME相对值、K-L分级的严重程度是术后1年HSS评分较差的预测因子。结论：术前更大程度的半月板突出、软骨损伤和更高级别的K-L分级与MOWHTO术后1年疗效较差有关系。

Abstract: Objective: To investigate the effect of medial mensical extrusion (MME) and cartilage injury on the clinical outcome after medial opening wedge high tibial osteotomy (MOWHTO) in patients with medial compartment osteoarthritis of the knee. Methods: Retrospective analysis was performed on the patients who underwent medial opening wedge high tibial osteotomy for medial compartment osteoarthritis of the knee in the Affiliated Hospital of Qingdao University. The patients were followed up preoperatively and at 1 month, 3 months, and 1 year postoperatively, and the HSS score and imaging examination were performed at the last follow-up to analyze the influencing factors of MOWHTO. Results: Preoperative HKA (P < 0.05), meniscus injury score (P < 0.05), BMI (P < 0.05), K-L grade (P < 0.05) were correlated with the severity of MME. Patients were divided into 4 groups according to the relative value of MME, and there were differences in HSS scores at 1 year after surgery between each group (P < 0.05). Multivariate regression analysis showed that cartilage injury score, relative value of MME and severity of K-L grading were predictors of poor HSS scores at 1 year after surgery. Conclusion: Greater MME, cartilage injury, and higher K-L grade were associated with poorer postoperative outcomes 1 year after MOWHTO.