Deparment of Orthopaedic Surgery, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Deparment of Orthopaedic Surgery, Hospital Regional Universitario de Málaga, Málaga, Spain.
J Knee Surg. 2021 Feb;34(3):267-272. doi: 10.1055/s-0039-1695041. Epub 2019 Aug 21.
The purpose of this study was to analyze the effect of obesity and other clinical factors on the outcome of meniscal allograft transplantation (MAT) with transosseous fixation. A retrospective cohort study was performed on patients who underwent a MAT between 2002 and 2017. All the participants had a minimum follow-up period of 24 months. The variables assessed were age at the time of the transplant, side, sex, transplanted meniscus (lateral/medial), body mass index (BMI), smoking status, and previous surgeries. Lysholm, Tegner, and International Knee Documentation Committee (IKDC) test outcomes, and patient satisfaction were recorded. Image assessment was performed using plain standing X-rays and a follow-up magnetic resonance imaging scan. Thirty-five patients fulfilled the inclusion criteria. The mean follow-up time was of 75.7 standard deviation (SD) 43.4 months. Patients with a BMI ≥ 30 underwent medial meniscal transplants (88.9 vs. 42.3%, = 0.022, respectively) more frequently. Obese patients had a significantly lower IKDC (48.6 SD 19.9 vs. 61.7 SD 13.1, = 0.038, power: 57.5%) and Lysholm (60.3 SD 19.2 vs. 79.4 SD 14.3, = 0.004, power: 88.7%) scores compared with nonobese patients. The satisfaction and Tegner scores were also lower in obese patients (55.6 vs. 80.7%, = 0.136, and 2.8 SD 1.0 vs. 4.0 SD 1.9, = 0.104, respectively); however, these differences were not statistically significant. Obese patients had higher rates of meniscal transplant failure compared with nonobese patients (adjusted hazard ratio: 11.8 [95% confidence interval: 1.5-91.4]). No differences were observed between obese and nonobese patients regarding age, sex, side, smoking status, and follow-up time. In this study, a BMI ≥ 30 kg/m resulted in higher MAT failure rates. Nonobese patients had better knee functional results compared with obese individuals.
本研究旨在分析肥胖和其他临床因素对经骨隧道固定的半月板同种异体移植（MAT）结局的影响。对 2002 年至 2017 年间接受 MAT 的患者进行了回顾性队列研究。所有参与者的随访时间均至少为 24 个月。评估的变量包括移植时的年龄、性别、侧别、移植半月板（外侧/内侧）、体重指数（BMI）、吸烟状况和既往手术史。记录 Lysholm、Tegner 和国际膝关节文献委员会（IKDC）评分以及患者满意度。影像学评估采用站立位平片和随访磁共振成像扫描。35 例患者符合纳入标准。平均随访时间为 75.7 标准差（SD）43.4 个月。BMI≥30 的患者更常接受内侧半月板移植（88.9%比 42.3%，=0.022）。肥胖患者的 IKDC（48.6 SD 19.9 比 61.7 SD 13.1，=0.038，功率：57.5%）和 Lysholm（60.3 SD 19.2 比 79.4 SD 14.3，=0.004，功率：88.7%）评分明显较低。肥胖患者的满意度和 Tegner 评分也较低（55.6%比 80.7%，=0.136 和 2.8 SD 1.0 比 4.0 SD 1.9，=0.104）；然而，这些差异没有统计学意义。与非肥胖患者相比，肥胖患者的半月板移植失败率更高（调整后的危险比：11.8 [95%置信区间：1.5-91.4]）。肥胖和非肥胖患者在年龄、性别、侧别、吸烟状况和随访时间方面无差异。在本研究中，BMI≥30kg/m 导致 MAT 失败率更高。与肥胖个体相比，非肥胖患者的膝关节功能结果更好。
