Lee Hyo Yeol, Bin Seong-Il, Kim Jong-Min, Lee Bum-Sik, Kim Seung-Min, Lee Seon-Jong
Department of Orthopaedic Surgery, Eulji Medical Center Daejeon Hospital, Eulji University College of Medicine, Daejeon, Republic of Korea; Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Arthroscopy. 2023 Apr;39(4):1000-1007. doi: 10.1016/j.arthro.2022.10.030. Epub 2022 Nov 1.
This study aimed to assess the cartilage status in patients who underwent isolated lateral meniscus allograft transplantation (MAT) using preoperative and postoperative quantitative 3-T magnetic resonance imaging T2 mapping at midterm follow-up period.
Patients who underwent lateral MAT without cartilage treatment procedures between 2010 and 2019 were assessed by quantitative magnetic resonance imaging preoperatively and postoperatively. On the sagittal section image following the center of the lateral femoral condyle, the weight-bearing area of the articular cartilage was divided into 6 segments based on the meniscal coverage area from anterior to posterior direction. The mean T2 values of each of the 6 segments were measured for 3 regions of interest: overall, deep, and superficial layers. The change in T2 values was statistically analyzed by paired t-tests. The Lysholm score was used to evaluate clinical function.
A total of 105 patients were included in the study. The mean follow-up period was 3.2 years (range 2.0-5.4 years). Among the 6 segments, the mean T2 value showed significant improvement in the overall layer of F2 (the middle weight-bearing area of femoral condyle) and TP3 (the posterior weight-bearing area of tibia condyle) segments (P = .013 and .021, respectively) and the superficial layer of the F3 (the posterior weight-bearing area of femoral condyle) segments (P = .028). The mean T2 value of all the other segments did not show a statistically significant change. The mean Lysholm score significantly improved from 66.5 ± 15.8 to 89.3 ± 10.0 (P < .001). Overall, 73.3% and 96.2% of the patients met the minimal clinically important difference and patient acceptable symptomatic state, respectively.
The mean T2 value of the articular cartilage of the weight-bearing area was either maintained or showed statistically significant improvement depending on the location following isolated lateral MAT. Thus, the transplanted meniscus seems to have a chondroprotective effect on the weight-bearing cartilage.
Level IV, retrospective therapeutic case series.
本研究旨在通过术前和术后中期随访的定量3-T磁共振成像T2映射,评估接受单纯外侧半月板同种异体移植(MAT)患者的软骨状态。
对2010年至2019年间接受外侧MAT且未进行软骨治疗的患者进行术前和术后定量磁共振成像评估。在沿外侧股骨髁中心的矢状面图像上,根据半月板覆盖面积从前往后方向,将关节软骨的负重区域分为6个节段。对每个节段的3个感兴趣区域(整体、深层和浅层)测量平均T2值。通过配对t检验对T2值的变化进行统计学分析。采用Lysholm评分评估临床功能。
本研究共纳入105例患者。平均随访期为3.2年(范围2.0 - 5.4年)。在6个节段中,F2节段(股骨髁中间负重区域)和TP3节段(胫骨髁后负重区域)的整体层以及F3节段(股骨髁后负重区域)的浅层平均T2值显示出显著改善(P分别为0.013和0.021以及0.028)。其他所有节段的平均T2值未显示出统计学上的显著变化。平均Lysholm评分从66.5±15.8显著提高到89.3±10.0(P < 0.001)。总体而言,分别有73.3%和96.2%的患者达到最小临床重要差异和患者可接受的症状状态。
单纯外侧MAT后,负重区域关节软骨的平均T2值根据位置要么保持不变,要么显示出统计学上的显著改善。因此,移植的半月板似乎对负重软骨具有软骨保护作用。
IV级,回顾性治疗病例系列。