| ABSTRACT Abstract: Objective: to analyze the risk factors of osteoarthritis (OA) of the knee after arthroscopic surgery for degenerative lesions of the posterior horn of the medial meniscus, and to make early interventions to improve the prognosis; Methods: the present study retrospectively analyzed 506 patients who underwent arthroscopic surgery for degenerative lesions of the posterior horn of the medial meniscus in our hospital from January 2012 to January 2014, with 230 males and 276 females, aged from 32 to 58 years old, mean age 46.77 (46.77 ± 9.021) years old; they were divided into groups that developed osteoarthritis of the knee and those that did not develop osteoarthritis according to the results of postoperative follow-up, and the gender, proximal medial tibial angle (MPTA), hip-knee-ankle angle, manifestation of bone edema on MRI, investigative features (McKnight's test, symptoms of strangulation, and medial pressure points of the knee), and meniscus ectopia were recorded for each of the study subjects, type of meniscal injury and free body condition (seen arthroscopically). A multifactorial unconditional logistic regression was used to analyze the factors associated with the incidence of osteoarthritis in the knee ten years after posterior horn degenerative injury of the medial meniscus, to screen for independent risk factors that might affect the occurrence of postoperative OA, and to create a columnar graphical prediction model for the occurrence of osteoarthritis in the postoperative period, and to evaluate the differentiation and accuracy of the model with the use of the C-index and the Hosmer-Lemeshow goodness-of-fit test. accuracy and were internally validated using a self-service resampling method. RESULTS: Within ten years after arthroscopy, there were 123 patients in the group with OA and 383 patients in the group without OA, and the differences in gender (χ2=5.156, P=0.023), MPTA<86.6° (χ2=21.671, P=0.000), lower limb force line entropion (χ2=80.086, P=0.000), meniscus ectropion (χ2=6.371, P= 0.012), transverse meniscal tear (χ2=14.573, P=0.000), and bone edema manifestation on MRI (χ2=9.881, P=0.002) were positively correlated with the prevalence of postoperative knee OA, with statistically significant differences, and the results of the multifactorial logistic regression showed that the lower limb line of force inversion (OR=4.324, P=0.011), MPTA <86.6° (OR=2.519, P=0.021), transverse meniscus tear (OR=4.546, P=0.001), meniscus ectropion (OR=5.401, P=0.001), and bone edema manifestation on MRI (OR=2.692, P=0.02); and the model-predicted lower product of the ROC curve was 0.927 (95% CI: 0.903-0.950), Hosmer-Lemeshow goodness-of-fit test for evaluating the accuracy of the model, P=0.689, and an internal sampling calibration curve suggesting good agreement with the actual postoperative occurrence of OA. Conclusion : Knee inversion, MPTA <86.6°, transverse meniscus tear, meniscal ectasia, and bone edema manifestation on MRI are independent risk factors for the development of osteoarthritis of the knee after arthroscopy, and the predictive ability of the prognostic model is good. |
