Ahn Ji Hyun, Kang Ho Won, Yang Tae Yeong, Lee Jang Yun
Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Ilsandonggu, Goyangsi, Gyeonggido, Republic of Korea.
Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Ilsandonggu, Goyangsi, Gyeonggido, Republic of Korea.
Arthroscopy. 2016 Jul;32(7):1337-45. doi: 10.1016/j.arthro.2015.12.050. Epub 2016 Mar 9.
To identify risk factors that predict major graft extrusion (>3 mm in relation to the margin of the tibial plateau) on magnetic resonance imaging (MRI) after lateral meniscus allograft transplantation (MAT) using multivariate logistic regression.
In this retrospective trial, inclusion criteria were consecutive lateral MATs from January 2004 to June 2013. Exclusion criteria were the lack of postoperative MRI, loss to follow-up for minimum 2 years, and simultaneous surgery of the articular cartilage or anterior cruciate ligament. According to the measured extent of graft extrusion in postoperative MRI, the lateral MATs were sorted into minor extrusion and major extrusion groups. Multivariate logistic regression was used to analyze risk factors including age, gender, body mass index, time from previous meniscectomy to MAT, extent of previous meniscectomy, previous anterior cruciate ligament reconstruction, knee alignment angle, Kellgren-Lawrence grade, lateral peripheral osteophyte, Outerbridge grade, posterior repair technique the position of bony bridge, and axial plane trough angle.
Enrolled 72 lateral MATs were sorted into minor extrusion (n = 34) and major extrusion groups (n = 38). As time from previous meniscectomy to lateral MAT increased, the risk of the major graft extrusion after lateral MAT increased (adjusted odds ratio: 1.554, 95% confidence interval: 1.089 to 2.218). Increased axial plane trough angle was also a significant risk factor (adjusted odds ratio: 8.449, 95% confidence interval: 1.710 to 42.250). The other parameters were not significant risk factors.
Most meniscal grafts after lateral MATs showed major graft extrusion. Significant risk factors for the major graft extrusion included delayed time from previous meniscectomy to MAT and increased axial plane trough angle.
Level III, retrospective comparative study.
采用多因素逻辑回归分析，确定在外侧半月板同种异体移植（MAT）后磁共振成像（MRI）上预测主要移植物挤出（相对于胫骨平台边缘超过3 mm）的危险因素。
在这项回顾性试验中，纳入标准为2004年1月至2013年6月连续进行的外侧MAT。排除标准为缺乏术后MRI、失访至少2年以及同时进行关节软骨或前交叉韧带手术。根据术后MRI测量的移植物挤出程度，将外侧MAT分为轻度挤出组和重度挤出组。采用多因素逻辑回归分析年龄、性别、体重指数、上次半月板切除至MAT的时间、上次半月板切除的范围、既往前交叉韧带重建、膝关节对线角度、Kellgren-Lawrence分级、外侧周边骨赘、Outerbridge分级、后修复技术、骨桥位置和轴平面槽角等危险因素。
纳入的72例外侧MAT分为轻度挤出组（n = 34）和重度挤出组（n = 38）。随着上次半月板切除至外侧MAT时间的增加，外侧MAT后主要移植物挤出的风险增加（调整优势比：1.554，95%置信区间：1.089至2.218）。轴平面槽角增加也是一个显著的危险因素（调整优势比：8.449，95%置信区间：1.710至42.250）。其他参数不是显著的危险因素。
大多数外侧MAT后的半月板移植物显示主要移植物挤出。主要移植物挤出的显著危险因素包括上次半月板切除至MAT的时间延迟和轴平面槽角增加。
III级，回顾性比较研究。
