Vasta Sebastiano, Zampogna Biagio, Hartog Taylor Den, El Bitar Youssef, Uribe-Echevarria Bastian, Amendola Annunziato
Orthopaedic and Traumatology Department, Campus Bio-Medical University, Rome, Italy.
University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Orthop J Sports Med. 2022 Mar 10;10(3):23259671221075310. doi: 10.1177/23259671221075310. eCollection 2022 Mar.
Outcomes following meniscal allograft transplantation (MAT) are an evolving topic.
To review clinical outcomes in younger, previously active patients who underwent an isolated MAT or MAT plus any osteotomy. Concurrent surgeries, complications, and graft survivorship are presented.
Case series; Level of evidence, 4.
Inclusion criteria included having undergone MAT with a minimum of 1 year of follow-up with at least 1 of the following patient-reported outcome (PRO) measures collected pre- and postoperatively: visual analog scale for pain, Knee injury and Osteoarthritis Outcome Score (KOOS), the Western Ontario and McMaster Universities Arthritis Index, the 36-Item Short Form Health Survey, and overall satisfaction. From patient records, we recorded descriptive data, side (medial/lateral), previous or concurrent procedures, perioperative complications, revisions, and conversion to arthroplasty. Two-factor analysis of variance (ANOVA) was used to test for differences in age and body mass index (BMI). A 2 × 2 chi-square test was used to determine if the spectrum of procedures performed on our study's patient group was representative of the entire population. PRO results were analyzed using a multivariate ANOVA.
From a total of 91 eligible patients, 61 (63 knees) met our inclusion criteria. Mean presurgery age was 25.5 ± 9.2 years, and mean BMI was 26.7 (range, 18.5-38.4). At follow-up (mean, 4.8 years; range, 1.0-13.6 years) overall PROs were statistically and clinically improved at final follow-up ( ≤ .003); effect sizes were moderate and large. KOOS Pain and KOOS Activities of Daily Living showed some main or interaction effects that were trivial or small. Patient satisfaction with the treatment was ≥7 out of 10 in 85% of patients. A minimum of 1 subsequent surgery for various concerns was necessary in 23% of the 93 knees. Graft survival in the included patients was 100%.
Complications (conditions requiring at least 1 subsequent surgery) affected about one-quarter of the patients who underwent MAT. Nevertheless, MAT seemed to provide our patients with adequate pain relief and improved function.
半月板同种异体移植(MAT)后的结果是一个不断发展的话题。
回顾接受单纯MAT或MAT联合任何截骨术的年轻、既往活跃患者的临床结果。介绍同期手术、并发症和移植物存活率。
病例系列;证据等级,4级。
纳入标准包括接受MAT且至少随访1年,术前和术后至少收集以下一项患者报告结局(PRO)指标:疼痛视觉模拟量表、膝关节损伤和骨关节炎结局评分(KOOS)、西安大略和麦克马斯特大学关节炎指数、36项简明健康调查以及总体满意度。从患者记录中,我们记录了描述性数据、患侧(内侧/外侧)、既往或同期手术、围手术期并发症、翻修情况以及转为关节成形术的情况。采用双因素方差分析(ANOVA)来检验年龄和体重指数(BMI)的差异。使用2×2卡方检验来确定我们研究患者组所进行的手术范围是否代表整个人群。使用多变量ANOVA分析PRO结果。
在总共91名符合条件的患者中,61名(63个膝关节)符合我们的纳入标准。术前平均年龄为25.5±9.2岁,平均BMI为26.7(范围18.5 - 38.4)。在随访时(平均4.8年;范围1.0 - 13.6年),最终随访时总体PRO在统计学和临床上均有改善(≤0.003);效应大小为中度和高度。KOOS疼痛和KOOS日常生活活动显示出一些主要或交互作用效应,这些效应微不足道或较小。85%的患者对治疗的满意度≥7分(满分10分)。在93个膝关节中,23%的患者因各种问题至少需要进行1次后续手术。纳入患者的移植物存活率为100%。
并发症(需要至少1次后续手术的情况)影响了约四分之一接受MAT的患者。然而,MAT似乎为我们的患者提供了充分的疼痛缓解并改善了功能。