中国骨科临床与基础研究杂志

目的 探讨老年盘状半月板损伤关节镜手术疗效，分析影响因素及术后炎症水平。方法 选取2021年3月至2024年3月在濮阳市中医院接受关节镜手术治疗的老年盘状半月板损伤患者80例，观察术后12个月疗效及其影响因素，分析手术前后核转录因子-κB(NF-κB)、人类软骨糖蛋白-39(YKL40)、血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平差异。结果 随访12个月，根据美国特种外科医院膝关节评分标准，优20例，良43例，可13例，差4例，优良率为78.75%(63/80)。Logistic回归分析显示，年龄（OR=0.443）、病程（OR=0.415）、手术类型（OR=3.401）是患者疗效的影响因素（P<0.05）。术后1个月患者血清NF-κB、YKL40、IL-6和TNF-α水平较术前明显改善，且半月板成形术患者明显低于其他手术类型患者，差异均有统计学意义（P<0.05）。结论 老年盘状半月板损伤关节镜手术疗效受年龄、病程、手术类型的影响，不同手术类型患者术后炎症水平存在差异。

Objective To explore the efficacy of arthroscopic surgery for senile discoid meniscus injury, and to analyze the infuence factors and postoperative inflammatory levels. Methods A total of 80 elderly patients with discoid meniscus injury who underwent arthroscopic surgery at Puyang Hospital of Traditional Chinese Medicine from March 2021 to March 2024 were selected. The therapeutic efficacy at 12 months postoperatively and its influencing factors were observed, and the differences in serum levels of nuclear factor-κ B(NF-κ B),human cartilage glycoprotein-39(HCgp-39, also known as YKL40), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α) were analyzed before and after surgery. Results At 12 months postoperatively, according to the Hospital for Special Surgery knee score, the efficacy was excellent in 20 cases, good in 43, fair in 13, and poor in 4 cases, with an excellent and good rate of 78.75%(63/80). Logistic regression analysis showed that age(OR = 0.443), course of disease(OR = 0.415), and surgical type(OR = 3.401) were influencing factors of therapeutic efficacy(P <0.05). At one month after surgery, the serum levels of NF-κB、YKL-40、IL-6 and TNF-αwere improved when compared with preoperative ones, and the above levels in patients undergoing meniscoplasty were significantly lower than those in patients undergoing other surgical types, with statistical differences(P <0.05). Conclusion The efficacy of arthroscopic surgery for senile discoid meniscus injury is affected by age, course of disease, and surgical type, and there are differences in postoperative inflammatory levels among patients with different surgical types.