II Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Department of Biomedical Sciences, Humanitas University, Humanitas Clinical and Research Center, Milan, Italy.
Arthroscopy. 2019 Aug;35(8):2448-2458. doi: 10.1016/j.arthro.2019.03.048.
To evaluate the influence of age on midterm clinical outcomes and failures of meniscal allograft transplantation (MAT), aiming at investigating the efficacy of MAT in patients older than 50 years.
In this case-control study, data on patients older than 50 years (older MAT [O-MAT] group) with at least 5 years of follow-up and a matched-pair group of patients younger than 30 years of age (younger MAT [Y-MAT] group) were extracted from a database of MAT procedures, performed with arthroscopic implantation of fresh-frozen meniscal allograft without bone plugs.
A matched-pair comparative analysis of midterm results and survival between 26 O-MAT patients and 26 Y-MAT patients was performed at a mean follow-up of 7.3 ± 2.2 years. All the clinical scores significantly improved from the baseline values in both the O-MAT and Y-MAT groups although with significantly lower scores in the O-MAT group. Two-thirds of O-MAT patients were able to return to a recreational level of sports activity. Only 2 patients in the O-MAT group underwent knee replacement, but the overall failure rate, also considering a clinical criterion, was 31% in the O-MAT group and 15% in the Y-MAT group (P = .3244). The mean survival time free from replacement or graft removal was 11.6 years in the O-MAT group and 12.3 years in the Y-MAT group (P = .691).
MAT is able to provide symptom relief and functional improvement at midterm follow-up in patients older than 50 years although with inferior results and a higher failure rate compared with those younger than 30 years. MAT can be considered a viable option to treat patients older than 50 years.
Level III, case-control study.
评估年龄对半月板同种异体移植（MAT）中期临床结果和失败的影响，旨在研究 50 岁以上患者行 MAT 的疗效。
在这项病例对照研究中，从 MAT 手术数据库中提取了至少随访 5 年的 50 岁以上患者（老年 MAT [O-MAT] 组）的数据，并与年龄小于 30 岁的患者（年轻 MAT [Y-MAT] 组）进行了配对比较。MAT 采用关节镜下植入新鲜冷冻半月板同种异体移植物，不使用骨栓。
在平均随访 7.3±2.2 年时，对 26 例 O-MAT 患者和 26 例 Y-MAT 患者的中期结果和生存率进行了配对比较分析。O-MAT 和 Y-MAT 两组的所有临床评分均较基线显著改善，但 O-MAT 组的评分明显较低。2/3 的 O-MAT 患者能够恢复到娱乐性运动水平。O-MAT 组仅 2 例患者行膝关节置换术，但 O-MAT 组的总体失败率（包括临床标准）为 31%，Y-MAT 组为 15%（P=.3244）。O-MAT 组无置换或移植物取出的平均生存时间为 11.6 年，Y-MAT 组为 12.3 年（P=.691）。
MAT 可在 50 岁以上患者的中期随访中提供症状缓解和功能改善，尽管结果较差且失败率高于 30 岁以下患者。MAT 可作为治疗 50 岁以上患者的一种可行选择。
III 级，病例对照研究。
