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用于治疗部分半月板缺损的半月板支架-两年随访的临床和放射学结果。

Meniscal scaffold for the treatment of partial meniscal defect-clinical and radiological outcomes in a two-year follow-up.

机构信息

AO Clinic (Institute of Trauma, Orthopaedics and Sports Injury), Nazimabad No.4, Karachi, Pakistan.

Circle Bath Hospital, Bath, UK.

出版信息

Int Orthop. 2021 Apr;45(4):977-983. doi: 10.1007/s00264-020-04811-7. Epub 2020 Sep 19.

DOI:10.1007/s00264-020-04811-7
PMID:32949258
Abstract

PURPOSE

The aim of meniscal scaffolds is to fill the defect, allow regeneration of meniscal-like tissues, and to prevent long-term risk of cartilage wear and tear. The aim of this study was to evaluate clinical results after two years and magnetic resonance imaging (MRI) results a year after implantation of a meniscal scaffold.

METHODS

Fifteen patients were recruited into a prospective, single-arm, single-center study, and treated with meniscal scaffolds as a result of segmental meniscal defect due to previous partial meniscectomy. Patients were evaluated using functional knee scores used pre-operatively and 6, 12, and 24 months postoperatively. The radiological outcome was assessed using MRI at 12 months by evaluating scaffold size, morphology, and intensity according to the Genovese grading system. Cartilage assessment was completed according to The International Cartilage Repair Society (ICRS) score.

RESULTS

All patients completed a follow-up of 24 months. A statistically significant increase in mean levels of all functional scores was present in all patients. On the MRI, all but one of the patients presented an incorporated meniscal implant. In most of the patients (73%), the meniscal implant was a Genovese type III. Type II and III signal intensities were present in all scaffolds when compared with the residual meniscal tissue. A stable cartilage (ICRS) status was observed in 80% of the patients compared with the pre-operative cartilage scores.

CONCLUSION

In our case series of patients treated with the meniscal scaffold implant, we observed good clinical results at a two year follow-up. Furthermore, MRI findings suggest that meniscal scaffolds might have a beneficial effect on articular cartilage.

摘要

目的

半月板支架的目的是填充缺损,允许半月板样组织再生,并防止长期的软骨磨损风险。本研究的目的是评估植入半月板支架两年后的临床结果和植入一年后的磁共振成像(MRI)结果。

方法

15 名患者被纳入一项前瞻性、单臂、单中心研究,由于先前的部分半月板切除术导致半月板节段性缺损,接受半月板支架治疗。患者在术前和术后 6、12 和 24 个月使用功能膝关节评分进行评估。在 12 个月时通过 MRI 评估支架大小、形态和强度(根据 Genovese 分级系统)以及根据国际软骨修复协会(ICRS)评分评估软骨评估来评估放射学结果。

结果

所有患者均完成了 24 个月的随访。所有患者的所有功能评分的平均水平均有统计学显著增加。在 MRI 上,除 1 例患者外,所有患者均显示半月板植入物已被整合。在大多数患者(73%)中,半月板植入物为 Genovese Ⅲ型。与残留半月板组织相比,所有支架均显示出 II 型和 III 型信号强度。与术前软骨评分相比,80%的患者观察到稳定的软骨(ICRS)状态。

结论

在我们的半月板支架植入患者的病例系列中,我们在两年的随访中观察到良好的临床结果。此外,MRI 结果表明半月板支架可能对关节软骨有有益的影响。

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