Imaging evaluation of the hip-knee-ankle angle and osteoarthritis progression before and after partial meniscectomy for degenerative medial meniscus posterior root tear

doi:10.3969/j.issn.2095-4344.3862

Abstract

Abstract: BACKGROUND: Partial meniscectomy can effectively reduce the mechanical symptoms of degenerative medial meniscus posterior root tear, but it cannot prevent the progression of knee osteoarthritis, which may be related to the effect of lower limb force line on prognosis.
OBJECTIVE: To investigate the correlation between the progression of knee osteoarthritis and the hip-knee-ankle angle in patients with degenerative medial meniscus posterior root tears after partial meniscectomy.
METHODS: The medical records of 138 patients with degenerative medial meniscus posterior root tears treated by partial meniscectomy in 904 Hospital of the Joint Service Support Force of Chinese PLA from January to December 2014 were analyzed retrospectively. The average follow-up was (5.53±0.58) years. Patients were divided into group A (hip-knee-ankle angle > 176.2°, n=77) and group B (hip-knee-ankle angle ≤ 176.2°, n=61) according to the best truncation value of hip-knee-ankle angle before operation. Receiver operator characteristic (ROC) curve was used to analyze the predictive value of preoperative hip-knee-ankle angle to postoperative American special surgery hospital score HSS. Spearman correlation analysis was used to explore the correlation between preoperative hip-knee-ankle angle and postoperative final HSS value. The width of knee medial joint space and Kaglan-Lawrence classification were compared between the two groups. The trial was approved by the Ethics Committee of 904 Hospital of the Joint Service Support Force of Chinese PLA (approval No. 2018-10-002).
RESULTS AND CONCLUSION: (1) The ROC curve showed that the preoperative hip-knee-ankle angle had a certain predictive value to the postoperative American special surgery hospital score HSS, and the area under the curve was 0.75. (2) Univariate Logistics regression analysis results showed that hip-knee-ankle angle and preoperative course of disease were influencing factors for postoperative HSS score. Multivariate Logistics regression analysis results showed that preoperative hip-knee-ankle angle was an independent risk factor for HSS score (P < 0.01), while body mass index and preoperative course of disease did not affect the correlation between hip-knee-ankle angle and HSS score. (3) Spearman correlation analysis results showed that the preoperative hip-knee-ankle angle was positively correlated with postoperative HSS score (r=0.472, P < 0.01). The greater the preoperative hip-knee-ankle angle and the higher the preoperative HSS score, the better the prognosis. (4) The width of postoperative joint space in group A was larger than that in group B (P < 0.01), and the degree of Kaglan-Lawrence grade in group A was lower than that in group B (P < 0.05), indicating progression of postoperative osteoarthritis in group A was slower than that in group B. (5) The results showed that for patients with degenerative medial meniscus posterior root tears, partial meniscectomy was not suitable if the hip-knee-ankle angle was ≤ 176.2°. Partial meniscectomy could be performed if the hip-knee-ankle angle was > 176.2°, but relevant risk factors should be carefully considered.

Key words: bone, meniscus, degeneration, meniscus posterior root tears, partial meniscectomy, hip-knee-ankle angle, osteoarthritis

CLC Number:

Peng Chao, Liu Yunpeng, Hua Guojun, Yang Jiaji, Wang Xingliang, Wang Xiaolong. Imaging evaluation of the hip-knee-ankle angle and osteoarthritis progression before and after partial meniscectomy for degenerative medial meniscus posterior root tear[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(21): 3368-3373.

Figures/Tables 9

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