通过对行关节镜下半月板成形缝合术治疗膝关节盘状半月板（DLM）损伤患者的疗效进行分析，筛选影响疗效的危险因素，构建风险预测模型，为提高DLM损伤疗效及预后提供参考。

纳入标准：有症状且MRI确诊为DLM损伤；WatanabeⅠ型或Ⅱ型；单侧病变、首次手术；资料完整，无膝部慢性病史。排除标准：需同期双侧手术；既往膝关节手术史或其他膝关节损伤；膝关节感染；有手术禁忌证。采用单中心自身对照队列研究设计，收集2020年1月至2024年1月在三峡大学附属仁和医院骨科行膝关节镜下行半月板成形缝合术的154例DLM损伤患者作为研究对象。采用Lysholm膝关节评分量表（LKSS）评价术后6个月时的疗效，并根据疗效分为两组，疗效优良组（评分≥70分）和疗效欠佳组（评分<70分）。通过单因素分析及多因素logistic回归模型分析筛选影响疗效的独立危险因素，构建预测模型。

患者术前及术后6个月时LKSS评分分别为（67±7）、（90±7）分，差异具有统计学意义（t=29.701，P<0.001）；术后6个月总体优良率为81.8%（126/154）。单因素及logistic回归多因素分析结果显示：年龄[比值比（OR）=1.189]、疾病病程（OR=1.054）及软骨损伤的Outerbridge分型（OR=1.251）是影响疗效的独立危险因素（均为P<0.05）。根据筛选出的独立危险因素构建预测模型，受试者工作特征（ROC）曲线下面积为0.894，临界值为90分，区分度良好。

患者年龄、疾病病程和软骨损伤Outerbridge分型是影响关节镜下半月板成形及缝合固定术治疗DLM损伤临床疗效的独立危险因素，相关危险因素可用于临床预后的风险预测，对于年龄大、疾病病程长和软骨损伤程度高的高风险患者（总分>90分）可以进行个体化的干预和治疗，并制定个性化治疗方案和康复计划。

To analyze the efficacy of arthroscopic meniscoplasty and suture fixation in treating discoid lateral meniscus (DLM) injuries, identify risk factors affecting outcomes, and construct a risk prediction model to provide a reference for improving the efficacy and prognosis of DLM injury treatment.

Inclusion criteria: MRI-confirmed DLM injury with symptoms; Watanabe type I or II; unilateral involvement and first-time arthroscopic surgery; complete clinical data without chronic knee diseases. Exclusion criteria: requirement for simultaneous bilateral surgery; history of knee surgery or other knee injuries; concurrent knee infection; surgical contraindications. A single-center, self-controlled cohort study was conducted. A total of 154 patients with DLM injuries who underwent arthroscopic meniscoplasty and suture fixation at the Department of Orthopedics, Renhe Hospital Affiliated to Three Gorges University between January 2020 and January 2024 were enrolled. Lysholm knee joint score scale (LKSS) was used to evaluate efficacy at six months after operation. The patients were divided into two groups based on efficacy: the excellent/good efficacy group (score ≥70) and the poor efficacy group (score <70). Univariation analysis and multivariate logistic regression analysis were performed to identify independent risk factors affecting efficacy, and a predictive model was constructed.

LKSS scores before surgeryand six monthsafter surgery were (67±7) and (90±7) respectively, with a statistically significant difference (t=29.701, P<0.001). The overall excellent efficacy rate at six months after operation was 81.8% (126/154). Univariation analysis and multivariate logistic regression analysis revealed that age [odds ratio (OR) = 1.189], disease duration (OR=1.054), and Outerbridge classification of cartilage injury (OR=1.251) were independent risk factors affecting efficacy ( all P<0.05). A predictive model was constructed based on these independent risk factors, with an area under the receiver operating characteristic (ROC) curve of 0.894 and a critical value of 90, indicating good discriminative ability.

Age, disease duration, and Outerbridge classification of cartilage injury are independent risk factors affecting the clinical efficacy of arthroscopic meniscoplasty and suture fixation for DLM injuries. These risk factors can be used for clinical prognosis risk prediction. High-risk patients (total score >90) with advanced age, prolonged disease duration, and severe cartilage injury may benefit from individualized interventions, treatments, and develop personalized treatment plans and rehabilitation programs.