| ObjectiveTo investigate the effect of discoid lateral meniscus on cartilage degeneration of knee joint. Whether there were differences between the effects of discoid lateral meniscus tears or not on articular cartilage degeneration. Correlation of discoid lateral meniscus with age, gender and body mass index, trauma, course of disease and articular cartilage degeneration of knee. To investigate the distribution characteistics of TCM syndromes in patients with meniscus injury.MethodsA total of 152 patients with 156 knees who had discoid lateral meniscus were included. According to the discoid lateral meniscus tear or not,all p atients were divided into two groups. Then record the site and analyse the degree of degeneration of articular cartilage of two groups of patients with MRI and arthroscopy. Using of chi square to analyze the the difference of cartilage degeneration rate between two groups of patients is statistically significant or not. In addition, according to the characteristics of the 94 patients with 94 knees who were treated with knee arthroscopic surgery, analyze the correlation between age, sex, body mass index, trauma history and course of disease and the degeneration of articular cartilage with two classification logistic regression. According the information of four diagnostic methods of the 82 patients with 82 knees whose discoid lateral meniscus injury, recod TCM syndrome type distribution. Statistical analysis was performed using SP SS20.0 software.Results1. According to the MRI of 152 knees of 156 patients, articular cartilage degeneration occurred in 38.46%, cartilage injury was found in 60 knees, a total of 102. The patellofemoral joint (patella and femoral trochlea) 40 (39.21%), medial room (medial femoral condyle and medial tibial plateau) 29 (28.43%), lateral room (femoral condyle and tibial plateau)33(32.35%). The cartilage injury proportion of patellofemoral joint and lateral compartment was higher than medial compartment. The cartilage degeneration degree of femoral condyle and lateral tibial plateau was higher than the femoral condyle and the medial tibial plateau. The articular surface of cartilage showed different degrees of injury and Ⅰ-Ⅱ injury accounted for 75.49%, higher than the level of III-IV which is 24.51%2. Observation of 94 cases of 94 kness arthroscopic, cartilage injury was found in 29 knee(30.85%)with different degrees, a total of 56. The patellofemoral joint 17(30.36%),lateral ventricular 23(41.07%) and prop-ortion of both injury were higher than medial compartment 16 (28.57%). For patellofemoral joint cartilage injury and lateral compartment was higher than the proportion of medial compartment. Grade Ⅰ-Ⅱ injury accounted for 58.93%, higher than that of grade Ⅲ-Ⅳ 41.07%.3.152 cases of 156 patients in discoid lateral meniscus group with intact knee cartilage degeneration rate was 43.24%, higher than the DLM damage in the 34.15%groups by chi square analysis showed that P=0.24 (P>0.05). The two group s of patients have no statistically significant difference between the rate of cartilage degeneration.In 94 patients with 94 knees,82 patients with DLM injury,21 knees with cartilage degeneration were found in these patients. The DLM of 12 patients with and 12 knees have no injury,8 patients with 8 knees of these patients have cartilage degeneration.4. To make all the independent variables into the method to carry out Logistic regression analysis, found that only the age of P=0.00, less than the significant level of 0.05, and the rest of the independent variables p value is greater than the significant level. Therefore, the step wise selection strategy (LR) was used to screen the independent variables. In the first step, gender(p=0.94), BMI (p=0.68), history of trauma (p=0.46), the course of P =0.50 (P=＞0.05), were all excluded. Age P=0.00 is an independent risk factor for DLM combined with articular cartilage injury (P<0.05). Patients older than 40 years of age were more likely to have a joint cartilage injury.5.94cases of 94 knees with DLM injury patients,36 males and 58 females, according to the five kinds of TCM syndrome type were given the dialectical typing, the statistics, the wind cold dampness arthralgia accounted for 15.96% and arthralgia of rheumatic fever other 22.34%, phlegm stasis Bizu representing 21.28%, spleen deficiency and dampness stagnation for 25.53%, deficiency of liver and kidney for 14.89%. Spleen deficiency and dampness stagnation syndrome, rheumatic fever arthralgia syndrome, phlegm and blood stasis higher stproportion. Liver and kidney deficiency syndrome at. According to gender classification, the likelihood ratio was 5.34, P=0.25(P>0.05), the difference between the five types of syndrome is not statistically significant. According to the age,<40 years old,40-50 years of age,50 years from three age, the likelihood ratio is 43.54, P=0.00(P<0.05), indicating that The differences of the distribution of five kinds of syndromes in different ages has statistical significance. The difference was statistically significant with deficiency of liver and kidney and the other four in the different age distribution (P<0.05). There was no significant difference in the rest of the distribution among age groups(P> 0.05). Age below of the patients for arthralgia due to wind cold dampness and arthralgia of rheumatic fever, sp utum silt Bi obstruction syndrome, spleen deficiency and dampness stagnation, spleen deficiency and dampness stagnation is most, liver and kidney deficiency syndrome in the least. Age above to 40 patients with deficiency of liver and kidney syndrome occurrence rate increased, especially when age above to 50 years old, deficiency of liver and kidney syndrome occur rate is higher. According to the course of disease is less than or equal to 2 months, and 12 months,12 months three course classification, the chi square analysis, it is concluded that the likelihood ratio is 43.54, P=0.01(p＜0.05), indicating that five syndromes distribution differences in different courses with statistical significance. The statistical significance of arthralgia syndrome of spleen deficiency and dampness stagnation syndrome, and the distribution of liver and kidney deficiency syndrome in different course of the difference between. For a long time does not heal, deep into the influence of viscera. Wind cold dampness arthralgia syndrome, arthralgia of rheumatic fever, phlegm stasis Bizu mainly in early, mid to spleen deficiency and dampness stagnation mainly late deficiency of the liver and kidney.21 cases of DLM trauma in 82 cases of 82 knees different TCM syndromes in cartilage degeneration and cartilage degeneration in 61 cases,it is concluded that the likelihood ratio 14.04, P=0.01 (P<0.05), indicating that five kinds of syndromes in cartilage degeneration distribution difference was statistically significant. Liver and kidney deficiency syndrome in patients with cartilage degeneration was the highest, followed by phlegm and blood stasis syndrome.Conclusion1. The effect of lateral meniscus injury on the knee joint cartilage degeneration was not significantly different.2. Age is a risk factor for articular cartilage degeneration in patients with lateral meniscus, and the incidence of articular cartilage was significantly increased at the age of 40 years. Although there is no significant correlation between gender, BMI, duration of diabetes, trauma and injury of the articular cartilage,but with the increase of BMI, duration, articular cartilage degeneration was significantly higher. Therefore,it is suggested that lateral discoid meniscus with weight control at the same time, and should be operated as soon as possible, as soon as possible, so as to avoid rapid degeneration of the knee joint.3. Different TCM syndrome type distribution in gender, in the majority of young patients who with lateral meniscus injury, spleen deficiency and damp ness stagnation, Qufeng desiccant and to invigorate the spleen. With increasing age, duration of diabetes, the proportion of deficiency of liver and kidney syndrome gradually increased, on elderly patients with discoid lateral meniscus injury, Shujin Tong luo and combined with drug for tonifying liver and kidney. |
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