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内侧和外侧改良前交叉韧带重建术后移植物挤出情况因手术技术而异:一项荟萃分析

Graft extrusion after medial and lateral MAT differs according to surgical technique: a meta-analysis.

作者信息

Bin Seong-Il, Kim Hyun-Jung, Lee Dae-Hee

机构信息

Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea.

Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea.

出版信息

Arch Orthop Trauma Surg. 2018 Jun;138(6):843-850. doi: 10.1007/s00402-018-2922-0. Epub 2018 Mar 28.

Abstract

INTRODUCTION

It is unclear whether the incidence and amount of graft extrusion differ between knees undergoing medial and lateral meniscus allograft transplantation (MAT). This meta-analysis, therefore, compared the incidence and amount of transplanted meniscus allograft extrusion following medial and lateral MAT.

MATERIALS AND METHODS

All studies comparing absolute or relative extrusions, or proportion of major extrusions (> 3 mm), on magnetic resonance imaging between medial and lateral MATs were included.

RESULTS

Eight studies were included in the meta-analysis. Using the arthroscopic-assisted technique, medial MAT had significantly greater absolute (0.99 mm, p = 0.002) and relative (19.4%, p = 0.001) extrusions than lateral MAT. Using the complete arthroscopic technique, lateral MAT had 1.45 mm greater absolute extrusion than medial MAT (p < 0.001), but there was no difference in relative extrusion. Using the arthroscopic-assisted technique, the proportion of knees with major extrusion was greater for medial than lateral MAT (OR 5.32, p < 0.001), but, using the complete arthroscopic procedure, there was no difference in proportions of major extrusions between medial and lateral MAT (OR 0.28, p = 0.08).

CONCLUSION

Graft extrusions after medial and lateral MAT differed according to surgical technique. Graft extrusion was greater after medial than lateral MAT using the arthroscopic-assisted technique, but was greater after lateral than medial MAT using the complete arthroscopic procedure.

LEVEL OF EVIDENCE

Meta-analysis (Level II).

摘要

引言

内侧和外侧半月板同种异体移植(MAT)的膝关节之间,移植物挤出的发生率和量是否存在差异尚不清楚。因此,本荟萃分析比较了内侧和外侧MAT后移植半月板同种异体移植物挤出的发生率和量。

材料与方法

纳入所有比较内侧和外侧MAT在磁共振成像上绝对或相对挤出、或主要挤出(>3mm)比例的研究。

结果

八项研究纳入荟萃分析。采用关节镜辅助技术时,内侧MAT的绝对挤出(0.99mm,p = 0.002)和相对挤出(19.4%,p = 0.001)均显著高于外侧MAT。采用全关节镜技术时,外侧MAT的绝对挤出比内侧MAT大1.45mm(p < 0.001),但相对挤出无差异。采用关节镜辅助技术时,内侧MAT主要挤出的膝关节比例高于外侧MAT(OR 5.32,p < 0.001),但采用全关节镜手术时,内侧和外侧MAT主要挤出的比例无差异(OR 0.28,p = 0.08)。

结论

内侧和外侧MAT后的移植物挤出因手术技术而异。采用关节镜辅助技术时,内侧MAT后的移植物挤出大于外侧MAT,但采用全关节镜手术时,外侧MAT后的移植物挤出大于内侧MAT。

证据水平

荟萃分析(二级)。

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