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

摘要:

[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]、mHKA [(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、mLDFA 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 un- der cuve, AUC） 分别为 0.807、0.954、0.791。[结论] AMA、JLCA 及 mLDFA 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。

Abstract:

[Objective] To investigate the correlation between lower limb alignment parameters and the extent of meniscal medial extrusion (MME) in knee osteoarthritis (KOA). [Methods] A total of 307 patients with KOA treated in our hospital from 2022 to 2023 were included 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 related to the degree of MME in KOA, and can be used as important parameters to evaluate the severity of MME.