Kimura Yuka, Yamamoto Yuji, Sasaki Shizuka, Sasaki Eiji, Sasaki Tomoyuki, Tsuda Eiichi, Ishibashi Yasuyuki
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Department of Orthopaedic Surgery, Hirosaki Memorial Hospital, Hirosaki, Japan.
Arthrosc Sports Med Rehabil. 2021 Sep 10;3(6):e1679-e1685. doi: 10.1016/j.asmr.2021.07.024. eCollection 2021 Dec.
To investigate the clinical outcomes following meniscus allograft transplantation (MAT) to replace removed discoid lateral meniscus using intact lateral meniscus obtained from patients undergoing total knee arthroplasty for medial compartment osteoarthritis.
Pediatric patients who underwent MAT secondary to partial or total meniscectomy due to discoid lateral meniscus between August 2010 and November 2018 were identified. Lateral menisci with bone blocks were transplanted arthroscopically. The demographic data, range of motion, meniscal allograft failure, which was defined as removal of an implanted meniscus, and complications were recorded. The Lysholm score and the Kellgren-Lawrence (KL) grade on radiographs were evaluated preoperatively and at final follow-up. The Knee injury and Osteoarthritis Outcome Score was evaluated in the final follow-up.
Eight patients who were symptomatic after discoid lateral meniscectomy were included. Donated allografts were harvested from adult patients aged between 64 and 78 years (mean 70.5 years). The mean age at previous meniscectomy and MAT were 10.5 and 18.1 years, respectively. All patients were followed up for a mean time of 5.2 years, and there were no cases of meniscus failure and complication. The Lysholm score significantly improved from preoperative to the final follow-up. Preoperatively, 6 and 2 knees were of KL grades II and III, respectively. At final follow-up, no increased KL grade was observed in 5 patients; however, an increase by 1 grade was observed in 2 patients and an increase by 2 grades was observed in 1 patient. The Knee injury and Osteoarthritis Outcome Scores at the final follow-up were 87.2 for pain, 87.9 for symptoms, 95.4 for activities of daily living, 79.4 for sports, and 65.6 for quality of life.
Older lateral meniscus allografts obtained from knees of adult patients undergoing total knee arthroplasty and transplanted into younger patients with defects from discoid lateral meniscectomy resulted in improved Lysholm scores but no improvement in Tegner scores or knee motion. KL grades were unchanged in 5 of the 8 patients at the final follow-up.
IV, therapeutic case series.
研究使用从因内侧间室骨关节炎接受全膝关节置换术的患者获取的完整外侧半月板，进行半月板同种异体移植（MAT）以替代切除的盘状外侧半月板后的临床结果。
确定2010年8月至2018年11月期间因盘状外侧半月板行部分或全半月板切除术后接受MAT的儿科患者。将带骨块的外侧半月板进行关节镜下移植。记录人口统计学数据、活动范围、半月板同种异体移植失败（定义为植入半月板的移除）及并发症。术前及末次随访时评估Lysholm评分及X线片上的Kellgren-Lawrence（KL）分级。末次随访时评估膝关节损伤和骨关节炎结局评分。
纳入8例盘状外侧半月板切除术后有症状的患者。捐赠的同种异体半月板取自64至78岁（平均70.5岁）的成年患者。既往半月板切除术和MAT时的平均年龄分别为10.5岁和18.1岁。所有患者平均随访5.2年，无半月板失败及并发症病例。从术前到末次随访，Lysholm评分显著改善。术前，KL分级为II级和III级的膝关节分别有6例和2例。末次随访时，5例患者KL分级未增加；然而，2例患者KL分级增加1级，1例患者KL分级增加2级。末次随访时膝关节损伤和骨关节炎结局评分：疼痛为87.2分，症状为87.9分，日常生活活动为95.4分，运动为79.4分，生活质量为65.6分。
从接受全膝关节置换术的成年患者膝关节获取的较老外侧半月板同种异体移植到患有盘状外侧半月板切除术后缺损的较年轻患者中，可使Lysholm评分提高，但Tegner评分或膝关节活动度无改善。8例患者中5例在末次随访时KL分级未改变。
IV，治疗性病例系列。
