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在前交叉韧带重建后的内侧半月板同种异体移植患者中,使用中央前骨栓可减少移植物挤出。

Centralized anterior bone plug results in less graft extrusion in patients undergoing medial meniscus allograft transplantation following anterior cruciate ligament reconstruction.

作者信息

Yoon Kyoung Ho, Lee Hyun Woo, Park Soo Yeon, Kim Jung-Suk, Park Jae-Young

机构信息

Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, Republic of Korea.

Department of Physical Education, Graduate School of Education, Yongin University, Yongin, South Korea.

出版信息

Knee. 2020 Jun;27(3):884-890. doi: 10.1016/j.knee.2020.02.014.

Abstract

PURPOSE

This study was performed to analyze the effect of anterior bone plug positioning on clinical and radiological outcomes in patients undergoing medial meniscus allograft transplantation (M-MAT) following anterior cruciate ligament reconstruction (ACLR).

METHODS

Data from 24 patients who underwent M-MAT following meniscectomy and ACLR from November 2008 to June 2017 were retrospectively investigated. Patients were divided into either the centrally positioned group (group C) or the medially positioned group (group M) based on the location of the anterior bone plug for M-MAT. Clinical and radiographic follow-up was performed at two years postoperatively. International Cartilage Repair Society (ICRS) grades of chondral lesion, graft extrusion, and meniscus signal intensity were evaluated by magnetic resonance imaging (MRI) at one year postoperatively.

RESULTS

There were no significant differences in demographics including follow-up time of two years between the two groups. There were no significant differences in postoperative subjective International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores between groups. Furthermore, there were no significant differences in osteoarthritis progression or ICRS grade on MRI. However, group C showed significantly less absolute graft extrusion (P = .008) and relative graft extrusion (P < .0001) on one-year follow-up MRI, relative to group M. Meniscus signal intensity tended to be better in group C, although this difference was not statistically significant (P = .092).

CONCLUSION

The centrally positioned group showed significantly less graft extrusion on MRI compared to the medially positioned group; however, there were no statistically significant differences in clinical outcomes between the two groups.

摘要

目的

本研究旨在分析前交叉韧带重建(ACLR)后行内侧半月板同种异体移植(M-MAT)患者中,前骨栓位置对临床和影像学结果的影响。

方法

回顾性研究2008年11月至2017年6月期间24例行半月板切除术和ACLR后接受M-MAT的患者的数据。根据M-MAT前骨栓的位置,将患者分为中央定位组(C组)或内侧定位组(M组)。术后两年进行临床和影像学随访。术后一年通过磁共振成像(MRI)评估国际软骨修复协会(ICRS)软骨损伤分级、移植物挤出情况和半月板信号强度。

结果

两组患者的人口统计学数据(包括两年的随访时间)无显著差异。两组患者术后主观国际膝关节文献委员会(IKDC)、Lysholm和Tegner评分无显著差异。此外,MRI上骨关节炎进展或ICRS分级也无显著差异。然而,与M组相比,C组在术后一年的随访MRI上显示出绝对移植物挤出(P = 0.008)和相对移植物挤出(P < 0.0001)明显更少。C组半月板信号强度倾向于更好,尽管这种差异无统计学意义(P = 0.092)。

结论

与内侧定位组相比,中央定位组在MRI上显示出移植物挤出明显更少;然而,两组之间的临床结果无统计学显著差异。

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