Department of Orthopaedics, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2333 ZA, Leiden, The Netherlands.
Department of Orthopaedic Surgery and Traumatology, Haaglanden Medical Center, The Hague, The Netherlands.
Knee Surg Sports Traumatol Arthrosc. 2020 Nov;28(11):3551-3560. doi: 10.1007/s00167-020-06276-y. Epub 2020 Sep 26.
Evaluation of survival of meniscal allograft transplantation (MAT) and postoperative patient-reported outcome (PRO), and their association with prior interventions of the knee.
A prospective consecutive study of 109 consecutive patients who had an arthroscopic meniscal allograft transplantation (MAT) between 1999 and 2017 by a single surgeon. Patients were assessed with KOOS scores, preoperative and after a minimal follow-up of 2 years. Furthermore, two anchor questions (whether expectations were met and overall satisfaction, on a five-point Likert scale) were asked. Additionally, prior interventions to MAT were evaluated.
Prior to MAT, patients had undergone an average of 2.8 (range 1-14) of surgical procedures of the knee. Overall, mean allograft survival was 16.1 years (95% CI 14.8-17.5 years). Higher age at surgery was associated with lower MAT survival: hazard ratio for MAT failure was 1.19 per year increase (95% CI 1.04 to 1.36, p = 0.009). At 4.5 years (IQR, 2-9) of follow-up, all KOOS score were still improved compared to baseline. Age below 35 years, simultaneous anterior cruciate ligament reconstruction and number of knee surgeries before MAT were associated with lower KOOS scores. Overall patient expectations and overall satisfaction after MAT were not associated with preoperative patient characteristics nor with the number or kind of preoperative interventions.
Meniscal allograft transplantation has a good overall survival with a clinically relevant improvement. Both meniscal allograft survival and PRO were associated with age. PRO was lower in patients younger than 35 years at time of MAT and meniscal allograft survival was worse in patients older than 50 years. PRO was associated with preoperative patient characteristics and number of surgical procedures prior to MAT. All patients reported improved postoperative satisfaction and met expectations after MAT, both independent of the preoperative history of knee interventions.
Level III. Trial registration Medical ethical review board (METC) number: 17-104 (7 August 2017). Dutch Trial Register (NTR) number: NTR6630 (4 July 2017).
评估半月板同种异体移植（MAT）的存活率和术后患者报告的结果（PRO），并分析其与膝关节既往干预的关系。
这是一项前瞻性连续研究，纳入了 1999 年至 2017 年间由同一位外科医生进行的 109 例关节镜半月板同种异体移植（MAT）的连续患者。患者接受了 KOOS 评分评估，术前和至少 2 年的随访后进行评估。此外，还询问了两个锚定问题（是否满足期望和整体满意度，五分制量表）。此外，还评估了 MAT 之前的干预措施。
在 MAT 之前，患者平均接受了 2.8 次（范围 1-14 次）膝关节手术。总体而言，同种异体移植物的平均存活率为 16.1 年（95%CI 14.8-17.5 年）。手术时年龄较大与 MAT 存活率较低相关：MAT 失败的风险比为每年增加 1.19（95%CI 1.04 至 1.36，p=0.009）。在 4.5 年（IQR，2-9）的随访中，所有 KOOS 评分均较基线有所改善。年龄小于 35 岁、同时进行前交叉韧带重建和 MAT 前膝关节手术次数与较低的 KOOS 评分相关。MAT 后患者的总体期望和总体满意度与术前患者特征以及术前干预的数量或类型无关。
半月板同种异体移植的整体存活率较好，且具有临床相关的改善。半月板同种异体移植物的存活率和 PRO 均与年龄相关。MAT 时年龄小于 35 岁的患者 PRO 较低，年龄大于 50 岁的患者同种异体移植物存活率较差。PRO 与 MAT 前的患者特征和手术次数相关。所有患者报告术后满意度提高，并且满足期望，两者均与膝关节干预的术前病史无关。
III 级。医学伦理审查委员会（METC）编号：17-104（2017 年 8 月 7 日）。荷兰试验注册处（NTR）编号：NTR6630（2017 年 7 月 4 日）。
