中国当代医药2026，Vol.33Issue(19)：4-9,6.DOI:10.3969/j.issn.1674-4721.2026.19.02
老年全膝关节置换术后膝关节活动受限的影响因素及预测模型的构建与验证
Influencing factors for restricted knee joint movement after total knee arthroplasty in the elderly and construction and verification of prediction model
摘要
Abstract
Objective To explore the influencing factors of restricted knee joint movement in elderly undergoing total knee arthroplasty(TKA)and to construct and validate a predictive model.Methods A total of 320 elderly TKA patients from Yichun People's Hospital from December 2021 to May 2024 were selected as the research subjects.They were divided into training group(n=224)and validation group(n=96)at a ratio of 7∶3.The patients were followed up for 1 year after surgery.The training group was further divided into restricted group and unrestricted group based on the knee joint activity.Univariate and multivariate logistic regression analyses were used to identify the independent risk factors for restricted knee joint movement.The validation group underwent external validation.Results A total of 38 cases(16.96％)in the training group experienced restricted knee joint movement.The results of univariate analysis showed that body mass index(BMI),preoperative knee joint range of motion,intraoperative incision suture flexion angle,postoperative joint line height change,and knee joint position were associated with postoperative knee joint dysfunction,and the differences were statistically significant(P＜0.05).The results of multivariate logistic regression analysis showed that BMI(β=1.343,OR=3.830,95％CI:1.516-9.675),preoperative knee joint range of motion(β=0.984,OR=2.675,95％CI:1.092-6.553),postoperative joint line height change(β=1.251,OR=3.494,95％CI:1.391-8.779),postoperative knee joint position(β=1.055,OR=2.873,95％CI:1.173-7.036),intraoperative incision suture flexion 90°(β=2.446,OR=11.537,95％CI:3.114-42.735),and exten-sion(β=1.896,OR=6.661,95％CI:1.988-22.317)were all independent risk factors for postoperative knee joint dysfunc-tion in elderly TKA patients(P＜0.05).The Hosmer-Lemeshow test of the nomogram model showed x2=3.737(P＞0.05),the ROC curve of the training group had an AUC of 0.796(95％CI:0.728-0.863),with sensitivity was 53.2％and specificity was 94.7％,and the discrimination was good.The AUC of the ROC curve for the validation group was 0.857(95％CI:0.743-0.970),with sensitivity was 75.0％and specificity was 90.0％.The DCA thresholds for both groups ranged from 0.00-1.00.Conclusion The constructed risk prediction model in this study has good clinical warning value and can assist medical staff in early identification of high-risk patients,providing a reference for clinical diagnosis and treatment and nursing.关键词
全膝关节置换术/膝关节活动受限/危险因素/风险预测模型/模型验证Key words
Total knee arthroplasty/Restricted knee joint movement/Risk factors/Risk prediction model/Model validation分类
医药卫生引用本文复制引用
晏淑芬,陈长莲,简梦琪..老年全膝关节置换术后膝关节活动受限的影响因素及预测模型的构建与验证[J].中国当代医药,2026,33(19):4-9,6.基金项目
江西省卫生健康委科技计划项目(202312208). （202312208）
