Pengas I P, Assiotis A, Nash W, Hatcher J, Banks J, McNicholas M J
Percivall Pott Rotation, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.
J Bone Joint Surg Br. 2012 Dec;94(12):1649-54. doi: 10.1302/0301-620X.94B12.30562.
We continued a prospective longitudinal follow-up study of 53 remaining patients who underwent open total meniscectomy as adolescents and who at that time had no other intra-articular pathology of the knee. Their clinical, radiological and patient-reported outcomes are described at a mean follow-up of 40 years (33 to 50). The cohort of patients who had undergone radiological evaluation previously after 30 years were invited for clinical examination, radiological evaluation and review using two patient-reported outcome measures. A total of seven patients (13.2%) had already undergone total knee replacement at the time of follow-up. A significant difference was observed between the operated and non-operated knee in terms of range of movement and osteoarthritis of the tibiofemoral joint, indicating a greater than fourfold relative risk of osteoarthritis at 40 years post-operatively. All patients were symptomatic as defined by the Knee Injury and Osteoarthritis Outcome Score. This study represents the longest follow-up to date and it can be concluded that meniscectomy leads to symptomatic osteoarthritis of the knee later in life, with a resultant 132-fold increase in the rate of total knee replacement in comparison to their geographical and age-matched peers.
我们继续对53名剩余患者进行前瞻性纵向随访研究，这些患者在青少年时期接受了开放性全半月板切除术，且当时膝关节无其他关节内病变。在平均40年（33至50年）的随访中描述了他们的临床、放射学和患者报告的结果。之前在30年后接受过放射学评估的患者队列被邀请进行临床检查、放射学评估，并使用两种患者报告的结局指标进行复查。随访时共有7名患者（13.2%）已经接受了全膝关节置换术。在活动范围和胫股关节骨关节炎方面，手术膝关节和未手术膝关节之间观察到显著差异，表明术后40年骨关节炎的相对风险增加了四倍多。根据膝关节损伤和骨关节炎结局评分，所有患者均有症状。这项研究是迄今为止最长时间的随访，可以得出结论，半月板切除术会导致晚年出现有症状的膝关节骨关节炎，与地理和年龄匹配的同龄人相比，全膝关节置换率增加了132倍。
