Akkaya Mustafa, Şimşek Mehmet Emin, Gürsoy Safa, Çay Nurdan, Bozkurt Murat
Department of Orthopedics and Traumatology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey.
Department of Orthopedics and Traumatology, Faculty of Medicine, Lokman Hekim University, Ankara, Turkey.
J Knee Surg. 2020 Aug;33(8):838-846. doi: 10.1055/s-0040-1701452. Epub 2020 Feb 10.
The objective of this study is to show the short-term clinical and radiological outcomes of concentrated bone marrow aspirate (CBMA) injection administered in combination with medial meniscus scaffold implantation. Twenty-three patients who received intra-articular CBMA injection in combination with polyurethane-based medial meniscus scaffold implantation were evaluated within the scope of this study. The International Knee Documentation Committee (IKDC) questionnaire and the Knee injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate the results, and the visual analog scale was used to assess the pain scores. Magnetic resonance imaging (MRI) scans were obtained in the preoperative period and at postoperative months 1, 12, 24, and 36 to assess the scaffold position as well as chondral degeneration/damage in a comparative manner. MRI assessment was performed by using the modified Outerbridge scale for cartilage and the Genovese scoring system for the meniscal implant. Twenty-three patients who were included in the study were evaluated for a mean follow-up period of 38.3 months. Patients exhibited statistically significant improvement according to all scoring data from the preoperative period until the follow-up period. The mean postoperative extrusion at year 3 was 2.39 mm (distribution 2.30-2.56 mm). There was no significant difference in the distribution of the degree of chondral damage between the preoperative and 3-year follow-up periods. Four patients did not show any improvement nor had lower scores according to the assessment. Medial meniscus scaffold implantation combined with intra-articular CBMA injection resulted in a significant improvement in all functions and pain scores as well as a statistically significant clinical improvement in IKDC and KOOS values in the short-term follow-up. The Level of evidence for this study is IV.
本研究的目的是展示浓缩骨髓抽吸物(CBMA)注射联合内侧半月板支架植入的短期临床和放射学结果。本研究评估了23例接受关节内CBMA注射联合聚氨酯基内侧半月板支架植入的患者。采用国际膝关节文献委员会(IKDC)问卷和膝关节损伤与骨关节炎疗效评分(KOOS)来评估结果,并用视觉模拟量表评估疼痛评分。在术前以及术后1个月、12个月、24个月和36个月进行磁共振成像(MRI)扫描,以比较评估支架位置以及软骨退变/损伤情况。通过使用改良的Outerbridge软骨评分量表和半月板植入物的Genovese评分系统进行MRI评估。纳入研究的23例患者平均随访38.3个月。根据从术前到随访期的所有评分数据,患者均表现出统计学上的显著改善。术后第3年的平均挤出量为2.39毫米(范围为2.30 - 2.56毫米)。术前和3年随访期之间软骨损伤程度的分布没有显著差异。根据评估,有4例患者没有表现出任何改善,评分也没有降低。内侧半月板支架植入联合关节内CBMA注射在短期随访中使所有功能和疼痛评分均有显著改善,IKDC和KOOS值也有统计学上的显著临床改善。本研究的证据等级为IV级。