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采用改良骨栓技术并进行解剖学半月板根部重新植入的半月板同种异体移植术后的临床和影像学结果及至少18个月的随访。

Clinical and radiologic outcomes after a modified bone plug technique with anatomical meniscal root reinsertion for meniscal allograft transplantation and a minimum 18-month follow-up.

作者信息

Ren Shiyou, Zhang Xintao, You Tian, Jiang Xiaocheng, Jin Dadi, Zhang Wentao

机构信息

Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, 1120 Lianhua Road, Futian District, Shenzhen, 518036, Guangdong, China.

Department of Orthopaedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.

出版信息

J Orthop Surg Res. 2018 Apr 24;13(1):97. doi: 10.1186/s13018-018-0776-3.

Abstract

OBJECTIVE

To evaluate the clinical and radiologic outcomes of meniscal allograft transplantation (MAT) using a modified bone plug technique.

METHODS

We conducted a retrospective single-center study of 73 patients who underwent MAT between January 2007 and December 2013. The International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner score, visual analogue scale (VAS), and physical examinations were retrospectively reviewed to measure clinical outcomes after MAT, and questionnaires regarding activity and factors were analyzed. Magnetic resonance imaging (MRI) was used to assess the cartilage status and meniscal extrusion.

RESULTS

The mean follow-up was 37 months for 61 patients (65 knees), and 12 patients were lost to follow-up. The mean meniscal extrusion was 3.39 ± 0.90 mm, the relative percentage of extrusion (RPE) was 34.82% ± 12.71%, and arthrosis progression was observed in 8 of 61 cases (13.1%). The mean results for VAS, IKDC, and Lysholm scores were significantly improved after MAT (P < 0.05), but there were no significant differences in the range of motion or Tegner score (P > 0.05). Thirty-eight (62.3%) patients were able to return to their previous level of activity, and 23 (37.7%) patients reached a mean 76.7% of the previous level of activity. Of the 23 patients reporting a decrease in activity, 10 reported a fear of reinjury as the primary factor limiting activity. The patient satisfaction rate in the study was 78.7%.

CONCLUSION

Our modified bone plug method with anatomical meniscal root reinsertion was an effective surgical method, and the majority of active patients with meniscal disorders returned to preinjury levels of activity.

摘要

目的

采用改良骨栓技术评估半月板同种异体移植(MAT)的临床和影像学结果。

方法

我们对2007年1月至2013年12月期间接受MAT的73例患者进行了一项回顾性单中心研究。回顾国际膝关节文献委员会(IKDC)评分、Lysholm评分、Tegner评分、视觉模拟量表(VAS)和体格检查,以评估MAT后的临床结果,并分析有关活动和因素的问卷。采用磁共振成像(MRI)评估软骨状态和半月板挤出情况。

结果

61例患者(65个膝关节)的平均随访时间为37个月,12例患者失访。平均半月板挤出量为3.39±0.90mm,挤出相对百分比(RPE)为34.82%±12.71%,61例中有8例(13.1%)观察到关节病进展。MAT后VAS、IKDC和Lysholm评分的平均结果有显著改善(P<0.05),但活动范围或Tegner评分无显著差异(P>0.05)。38例(62.3%)患者能够恢复到先前的活动水平,23例(37.7%)患者达到先前活动水平的平均76.7%。在23例报告活动减少的患者中,10例报告害怕再次受伤是限制活动的主要因素。该研究中的患者满意率为78.7%。

结论

我们采用解剖学半月板根部重新植入法的改良骨栓方法是一种有效的手术方法,大多数活跃的半月板疾病患者恢复到了伤前的活动水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0be6/5916716/062acdeca977/13018_2018_776_Fig1_HTML.jpg

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