van der Wal Robert J P, Attia David, Waarsing Erwin H, Thomassen Bregje J W, van Arkel Ewoud R A
Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Department of Orthopaedic Surgery and Traumatology, Haaglanden Medical Center, The Hague, the Netherlands.
Knee. 2018 Dec;25(6):1091-1099. doi: 10.1016/j.knee.2018.06.005. Epub 2018 Jun 20.
The potential chondroprotective effect of meniscal allograft transplantation (MAT) is unclear. Subchondral bone mineral density (BMD) and subchondral bone remodeling play important roles in osteoarthritis development. Evaluation of subchondral BMD after MAT might give more insight into the potential chondroprotective effect. The purpose of this study was to determine early BMD changes in the knee after MAT.
Twenty-six consecutive patients underwent MAT during 2010-2013. The BMD was measured using dual-energy x-ray absorptiometry (DXA) scan preoperatively, and six months, one and two years postoperatively. Bone mineral density was measured in six regions of interest (ROIs) in the tibia and femur (medial, central, lateral) in both treated and healthy contralateral knees.
The BMD levels of MAT knees did not significantly change during two years of follow-up in almost all ROIs. Bone mineral density was significant higher in nearly all ROIs in MAT knees at almost all follow-ups compared to healthy contralateral knees. In the healthy contralateral knees, BMD slightly, but not statistically, decreased in the first postoperative year, where it normalized to baseline values at two-year follow-up. The BMD levels in all ROIs did not significantly differ between the patients with or without chondropathy at baseline and two-year follow-up.
Based on the findings, MAT did not show a significant influence on BMD in the first two postoperative years. Longer follow-up is necessary to prove the potential chondroprotective effect of MAT using BMD measurements.
半月板同种异体移植（MAT）潜在的软骨保护作用尚不清楚。软骨下骨矿物质密度（BMD）和软骨下骨重塑在骨关节炎发展中起重要作用。评估MAT术后软骨下BMD可能有助于更深入了解其潜在的软骨保护作用。本研究的目的是确定MAT术后膝关节早期BMD的变化。
2010年至2013年期间，连续26例患者接受了MAT。术前、术后6个月、1年和2年使用双能X线吸收法（DXA）扫描测量BMD。在治疗侧膝关节和对侧健康膝关节的胫骨和股骨的六个感兴趣区域（ROI）（内侧、中央、外侧）测量骨矿物质密度。
在两年的随访中，MAT膝关节几乎所有ROI的BMD水平均无显著变化。与对侧健康膝关节相比，在几乎所有随访中，MAT膝关节几乎所有ROI的骨矿物质密度均显著更高。在对侧健康膝关节中，术后第一年BMD略有下降，但无统计学意义，在两年随访时恢复至基线值。在基线和两年随访时，有或无软骨病的患者所有ROI的BMD水平无显著差异。
基于这些发现，MAT在术后的前两年对BMD没有显著影响。需要更长时间的随访，以通过测量BMD来证明MAT潜在的软骨保护作用。
