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半月板同种异体移植联合前交叉韧带重建后的临床疗效

Clinical outcomes after combined meniscal allograft transplantation and anterior cruciate ligament reconstruction.

作者信息

Sekiya Jon K, Giffin J Robert, Irrgang James J, Fu Freddie H, Harner Christopher D

机构信息

Center for Sports Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15203, USA.

出版信息

Am J Sports Med. 2003 Nov-Dec;31(6):896-906. doi: 10.1177/03635465030310062701.

DOI:10.1177/03635465030310062701
PMID:14623655
Abstract

BACKGROUND

Concomitant meniscal transplantation performed at the time of ligament surgery may help to protect the anterior cruciate ligament graft.

PURPOSE

To determine the objective and subjective clinical outcomes after combined anterior cruciate ligament reconstruction and meniscal allograft transplantation.

STUDY DESIGN

Uncontrolled retrospective review.

METHODS

Twenty-eight patients who underwent anterior cruciate ligament reconstruction along with meniscal transplantation were retrospectively evaluated postoperatively at an average of 2.8 years (range, 1.8 to 5.6).

RESULTS

On the International Knee Documentation Committee overall subjective assessment, 86% had normal or nearly normal scores. The SF-36 physical and mental component summary scores were at higher levels than those of the patients' age- and sex-matched populations. Objectively, nearly 90% had normal or nearly normal Lachman and pivot shift test scores. The KT-1000 arthrometer testing at 30 pounds and maximum manual both demonstrated an average increased anterior translation of 1.5 mm compared with the contralateral knee. Joint space narrowing of the transplanted compartments was not significantly different from that of the contralateral knee.

CONCLUSIONS

Meniscal transplantation with anterior cruciate ligament reconstruction can be a beneficial procedure in properly selected patients with either chronic anterior cruciate ligament insufficiency or failed anterior cruciate ligament surgery. Restoration of meniscal function may provide protection for the articular cartilage and improve joint stability.

摘要

背景

在韧带手术时同期进行半月板移植可能有助于保护前交叉韧带移植物。

目的

确定前交叉韧带重建联合半月板同种异体移植术后的客观和主观临床结果。

研究设计

非对照回顾性研究。

方法

对28例行前交叉韧带重建并半月板移植的患者进行回顾性评估,术后平均随访2.8年(范围1.8至5.6年)。

结果

根据国际膝关节文献委员会的总体主观评估,86%的患者得分正常或接近正常。SF-36身体和精神成分总结得分高于年龄和性别匹配人群。客观上,近90%的患者Lachman试验和轴移试验得分正常或接近正常。与对侧膝关节相比,在30磅负荷和最大手动负荷下进行的KT-1000关节测径仪测试均显示平均前向移位增加1.5毫米。移植半月板侧的关节间隙变窄与对侧膝关节无显著差异。

结论

对于慢性前交叉韧带损伤或前交叉韧带手术失败的合适患者,半月板移植联合前交叉韧带重建可能是一种有益的手术。半月板功能的恢复可为关节软骨提供保护并改善关节稳定性。

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