Rijk Paul C, Van Noorden C J F
Department of Orthopaedic Surgery, MCL North Hospital, Leeuwarden, The Netherlands.
Arthroscopy. 2002 Nov-Dec;18(9):995-1001. doi: 10.1053/jars.2002.36109.
To compare long-term performance of meniscal allografts transplanted immediately after meniscectomy and allografts transplanted 6 weeks after meniscectomy.
Experimental study.
Twenty-one rabbits were subjected to meniscectomy and divided into 3 groups of 7 animals. Immediate meniscal transplantation was performed in group A (6-week follow-up) and group B (1-year follow-up). Group C underwent delayed transplantation 6 weeks after meniscectomy. One animal in group B developed infective arthritis and was not included. Six nonoperated knees served as controls. Four other knees were subjected to a sham procedure. Menisci were examined macroscopically and histologically at 6 weeks (group A and 2 sham- operated animals) and 1 year (group B, C, controls, and 2 sham-operated animals).
Capsular ingrowth was observed in all allografts. At 1 year, osteoarthritic changes in the delayed transplant group were more pronounced than in the immediate transplant group. Menisci in nonoperated controls and sham-operated knees appeared normal. No differences in shrinkage of allografts were observed between groups A and B. Group C showed significantly more shrinkage than allografts in both group A (P =.004) and group B ( P =.005). Two allografts in group C were completely degenerated. Differences in architecture of the allografts were not found between groups A, B, and C. In both the peripheral and central areas of transplanted menisci, the number of cells was frequently increased because of repopulation even at 6-week follow-up.
Delayed meniscal allograft transplantation causes distinct structural damage to menisci in comparison with immediate transplantation.
比较半月板切除术后立即移植的同种异体半月板移植物与半月板切除术后6周移植的同种异体半月板移植物的长期性能。
实验研究。
21只兔子接受半月板切除术，并分为3组，每组7只动物。A组（6周随访）和B组（1年随访）进行即刻半月板移植。C组在半月板切除术后6周进行延迟移植。B组有1只动物发生感染性关节炎，未纳入研究。6个未手术的膝关节作为对照。另外4个膝关节接受假手术。在6周时（A组和2只接受假手术的动物）以及1年时（B组、C组、对照组和2只接受假手术的动物）对半月板进行宏观和组织学检查。
在所有同种异体移植物中均观察到包膜长入。1年时，延迟移植组的骨关节炎变化比即刻移植组更明显。未手术对照组和接受假手术的膝关节中的半月板外观正常。A组和B组之间在同种异体移植物收缩方面未观察到差异。C组的收缩明显多于A组（P = 0.004）和B组（P = 0.005）的同种异体移植物。C组有2个同种异体移植物完全退变。A组、B组和C组之间在同种异体移植物结构上未发现差异。即使在6周随访时，在移植半月板的周边和中央区域，由于细胞重新填充，细胞数量也经常增加。
与即刻移植相比，延迟同种异体半月板移植会对半月板造成明显的结构损伤。
