Bull Hosp Jt Dis (2013). 2022 Sep;80(3):239-245.
The purpose of this study was to evaluate for changes in the incidence of arthroscopic meniscal procedures, especially meniscal allograft transplantation (MAT) in New York State (NYS) between 2005 to 2014.
The New York Statewide Planning and Research Cooperative Systems (SPARCS) database was queried from 2005 through 2014 to identify patients undergoing meniscetomies, meniscal repairs, and MAT. Patients were followed longitudinally to determine the incidence of subsequent ipsilateral knee procedures. The impact of patient demographics and surgeon volume on reoperation was explored.
From 2005 through 2014, there were 524,737 arthroscopic meniscal procedures. Of these, there were 510,406 meniscectomies, 14,214 meniscal repairs, and 117 MATs. The number of MATs increased 15.5% per year, with the largest increase being between 2013 to 2014 (an increase of 86.5%). Average MAT patient age was 29.8 ± 11.1 years; 65.0% of patients were male; 66% were Caucasian; 84% were privately-insured; and 23% of surgeons met the criteria for high-volume (five or more MATs in a year). A total of 25.6% (30/117) patients underwent subsequent surgery; 26 patients underwent knee procedures at mean of 18.9 ± 18.3 months after initial MAT, the most common of which were ipsilateral meniscectomies (19/26). Four patients underwent total knee arthroplasty (TKA) at a mean of 21.0 ± 9.2 months after initial MAT. Patients undergoing TKA after MAT were significantly older (42.0 ± 15.0 years vs, 29.3 ± 10.7 years; p = 0.0242) than patients who did not. Neither demographics nor surgeon volume were statistically significant factors for undergoing subsequent surgery (p > 0.05).
Meniscal allograft transplantation, though relatively uncommon, is being performed with greater frequency in NYS. Surgeons should counsel patients regarding the likelihood of requiring subsequent knee surgery after MAT, with repeat arthroscopic partial meniscectomy being the most commonly performed procedure.
本研究旨在评估 2005 年至 2014 年期间纽约州（NYS）关节镜半月板手术的变化情况，尤其是半月板同种异体移植（MAT）的变化情况。
从 2005 年至 2014 年，通过纽约州全范围规划和研究合作系统（SPARCS）数据库，对接受半月板切除术、半月板修复术和 MAT 的患者进行了查询。对患者进行纵向随访，以确定同侧膝关节后续手术的发生率。还探讨了患者人口统计学和外科医生手术量对再手术的影响。
2005 年至 2014 年间，共进行了 524737 例关节镜半月板手术。其中，半月板切除术 510406 例，半月板修复术 14214 例，MAT 117 例。MAT 的数量每年增加 15.5%，2013 年至 2014 年增加幅度最大（增加 86.5%）。MAT 患者的平均年龄为 29.8±11.1 岁；65.0%为男性；66%为白种人；84%为私人保险；23%的外科医生符合高手术量（每年 5 例或以上 MAT）标准。共有 25.6%（30/117）的患者接受了后续手术；26 例患者在初次 MAT 后平均 18.9±18.3 个月接受了同侧膝关节手术，最常见的是同侧半月板切除术（19/26）。4 例患者在初次 MAT 后平均 21.0±9.2 个月接受了全膝关节置换术（TKA）。初次 MAT 后行 TKA 的患者年龄明显较大（42.0±15.0 岁 vs. 29.3±10.7 岁；p=0.0242）。患者的人口统计学和外科医生手术量均不是接受后续手术的统计学显著因素（p＞0.05）。
尽管半月板同种异体移植相对少见，但在 NYS 中进行的频率却越来越高。外科医生应告知患者 MAT 后可能需要再次进行膝关节手术的可能性，其中重复关节镜部分半月板切除术是最常进行的手术。
