Ahn Ji Hyun, Kang Ho Won, Yang Tae Yeong, Lee Jang Yun
Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Goyangsi, Gyeonggido, Republic of Korea.
Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Goyangsi, Gyeonggido, Republic of Korea.
Arthroscopy. 2016 Dec;32(12):2539-2546. doi: 10.1016/j.arthro.2016.04.023. Epub 2016 Jun 11.
To identify risk factors that predict radiographic progression of osteoarthritis after meniscus allograft transplantation (MAT) using multivariate logistic regression.
Inclusion criteria were consecutive patients who underwent medial or lateral MATs from January 2005 to September 2012 by one surgeon. Exclusion criteria were lack of postoperative magnetic resonance image, loss to follow-up for a minimum of 3 years, and simultaneous surgery on articular cartilage or the anterior cruciate ligament. According to the change of Kellgren-Lawrence (KL) grade at the mean final follow-up of 56.2 months, the enrolled MATs were sorted into the no progression of osteoarthritis (NOA) and progression of osteoarthritis (POA) groups. Multivariate logistic regression was used to analyze risk factors, including age, sex, body mass index, time from previous meniscectomy to MAT, extent of previous meniscectomy, previous anterior cruciate ligament reconstruction, knee alignment angle, KL grade, side of transplanted meniscus, Outerbridge grade, posterior repair technique, and relative percentage of extrusion.
In comparison between the NOA (n = 38) and the POA (n = 31) groups, a significant risk factor for radiographic progression of osteoarthritis after MAT was medial MAT compared with lateral MAT. Medial MAT compared with lateral MAT was also a significant risk factor (adjusted odds ratio, 3.763; 95% confidence interval, 1.212-11.683).
Patients need to be counseled about the increased risk of osteoarthritis progression after MAT over time, particularly for medial MAT.
Level III, retrospective case control study.
采用多因素逻辑回归分析，确定预测半月板同种异体移植（MAT）后骨关节炎影像学进展的危险因素。
纳入标准为2005年1月至2012年9月由同一位外科医生进行内侧或外侧MAT的连续患者。排除标准为缺乏术后磁共振成像、失访至少3年、同时进行关节软骨或前交叉韧带手术。根据平均末次随访56.2个月时Kellgren-Lawrence（KL）分级的变化，将纳入的MAT分为骨关节炎无进展（NOA）组和骨关节炎进展（POA）组。采用多因素逻辑回归分析危险因素，包括年龄、性别、体重指数、上次半月板切除至MAT的时间、上次半月板切除范围、既往前交叉韧带重建、膝关节对线角度、KL分级、移植半月板侧别、Outerbridge分级、后方修复技术和挤压相对百分比。
在NOA组（n = 38）和POA组（n = 31）的比较中，MAT后骨关节炎影像学进展的一个显著危险因素是内侧MAT与外侧MAT相比。内侧MAT与外侧MAT相比也是一个显著危险因素（调整比值比，3.763；95%置信区间，1.212 - 11.683）。
需要告知患者，MAT后骨关节炎随时间进展的风险增加，尤其是内侧MAT。
III级，回顾性病例对照研究。
