Construction of a nomogram prediction model for early surgical repair of multiple ligament injuries in knee dislocation

Qi Feicheng; Hong Junyi; Wang Wei; Yu Binjia; Pan Zhongyi; Chen Yansong; Xu Zhikun

doi:10.3969/j.issn.1002-1949.2025.09.009

Abstract：Objective To construct a nomogram prediction model for early surgical repair of multiple ligament injuries in knee dislocation.Methods The data of 258 patients with early surgery for multiple ligament injury of knee dislocation admitted to the Affiliated Xiaoshan Hospital of Hangzhou Normal University from April 2021 to April 2024 were reviewed,and were randomly divided into the training set(208 cases)and the validation set(50 cases)according to 8∶2.All the patients were given anterior and posterior cruciate ligament reconstruction by arthroscop and collateral ligament repair treatment at the early stage.The repair effect was examined after surgery,and the patients with obvious and effective effects were included in the effective repair group,and the patients with no repair effect were included in the ineffective repair group.The article analyzed the influence of disease severity and Lysholm score on the early surgical repair effect of multi-ligament injury of knee dislocation,established the prediction model of early surgical repair effect of multi-ligament injury of knee dislocation,verified the model and evaluated the efficacy.Results 46 cases(22.12％)of the training set were ineffective,and 14 cases(28.00％)of the validation set were ineffective.Logistic regression analysis showed that the degree of disease,Lysholm score and International Knee Documentation Committee(IKDC)score were risk factors for early surgical repair of multi-ligament knee dislocation injury.With the above influencing factors as predictive variables,a nomogram prediction model was established,and the C-index was 0.812(95％CI 0.778-0.834).The correction curve for predicting the early surgical repair effect of multiple ligament injuries of knee dislocation was close to the ideal curve(P＞0.05).ROC curve results of the training set showed that the sensitivity,specificity and AUC of the nomogram model to predict the early surgical repair effect of multiple ligament injuries of knee dislocations were 77.98％,82.03％and 0.853(95％CI 0.771-0.923).ROC curve results of validation set showed that the sensitivity,specificity and AUC of the nomogram model to predict the early surgical repair effect of multiple ligament injuries of knee dislocation were 72.01％,89.03％and 0.884(95％CI 0.810-0.955).Conclusions The degree of disease,Lysholm score and IKDC score are the factors that affect the early surgical repair effect of multi-ligament injury of knee dislocation.The nomogram model constructed based on above-mentioned indexes has a good predictive effect on the early surgical repair of multiple ligament injuries in knee dislocation.