Tufts Medical Center, Boston, Massachusetts, U.S.A.
Loma Linda University Medical Center, Loma Linda, California, U.S.A.
Arthroscopy. 2020 Jan;36(1):253-260. doi: 10.1016/j.arthro.2019.07.022.
To evaluate the time and rate of return to sport (RTS), as well as outcomes, in young and active patients receiving concomitant lateral meniscal allograft transplantation (MAT) and distal femoral varus osteotomy (DFVO) for lateral meniscal deficiency and valgus malalignment.
This was a retrospective study of consecutive patients who underwent concomitant MAT and DFVO by a single surgeon. The exclusion criteria were any concomitant procedures other than cartilage restoration procedures for focal full-thickness cartilage defects of the lateral femoral condyle and less than 2 years of follow-up. At final follow-up, patients were asked to complete a subjective sports questionnaire, the Marx Activity Rating Scale, a visual analog scale (VAS), the Single Assessment Numeric Evaluation, and a satisfaction questionnaire. Changes in patient-reported outcome measures were assessed using nonparametric statistical testing.
A total of 21 patients met the inclusion criteria, of whom 17 were included for analysis at an average follow-up of 7.5 years (range, 2.2-13.3 years). The average age at the time of surgery was 23.3 years (range, 16.9-36.2 years), and 76.5% of patients were female patients. The average VAS score decreased from 5.7 preoperatively to 2.6 postoperatively (P = .02). Of the 15 patients who participated in sports within 3 years prior to their surgical procedure, 14 (82.4%) returned to 1 or more sports at an average of 16.9 months (range, 6-36 months); however, only 46.7% were able to return to their preinjury level of participation or higher. Furthermore, 88.2% of patients reported being satisfied with their sport-related outcomes. Direct rates of sport-specific return were as follows: weightlifting, 100%; skiing, 100%; running, 66.7%; and basketball, 50%.
In our study population, concomitant MAT and DFVO afforded a high rate of RTS at an average of 16.9 months postoperatively, as well as a significant decrease in VAS pain scores. These findings are essential to note when counseling patients receiving these procedures who wish to resume sports and physical activities so that they may expect an extensive recovery process before they can RTS.
Level IV, case series.
评估同时接受外侧半月板同种异体移植（MAT）和股骨远端外翻截骨术（DFVO）治疗外侧半月板缺失和外翻畸形的年轻活跃患者的重返运动时间（RTS）和 RTS 率，以及结局。
这是一项由一位外科医生连续进行的同时接受 MAT 和 DFVO 的患者回顾性研究。排除标准是除外侧股骨髁局灶性全层软骨缺损的软骨修复手术以外的任何其他伴随手术，以及随访时间少于 2 年。在最终随访时，患者被要求完成一份主观运动问卷、Marx 活动评分量表、视觉模拟评分（VAS）、单因素评估数值评估和满意度问卷。使用非参数统计检验评估患者报告的结果测量指标的变化。
共有 21 名患者符合纳入标准，其中 17 名患者在平均 7.5 年（范围，2.2-13.3 年）的随访中进行了分析。手术时的平均年龄为 23.3 岁（范围，16.9-36.2 岁），76.5%的患者为女性。平均 VAS 评分从术前的 5.7 分降至术后的 2.6 分（P =.02）。在手术前 3 年内参加过运动的 15 名患者中，14 名（82.4%）在平均 16.9 个月（范围，6-36 个月）后恢复到 1 项或多项运动；然而，只有 46.7%的患者能够恢复到受伤前的运动参与水平或更高水平。此外，88.2%的患者对他们的运动相关结果表示满意。特定运动的直接 RTS 率如下：举重，100%；滑雪，100%；跑步，66.7%；篮球，50%。
在我们的研究人群中，同时进行 MAT 和 DFVO 治疗可使患者在术后平均 16.9 个月时获得较高的 RTS 率，并显著降低 VAS 疼痛评分。在为希望恢复运动和体育活动的接受这些手术的患者提供咨询时，这些发现至关重要，以便他们能够在恢复运动之前预期到一个广泛的康复过程。
IV 级，病例系列。
