Phillips Andrew R, Haneberg Erik C, Boden Stephanie A, Yanke Adam B, Cole Brian J
, Chicago, USA.
Curr Rev Musculoskelet Med. 2024 Sep;17(9):343-352. doi: 10.1007/s12178-024-09904-z. Epub 2024 Jun 18.
To reduce pain, improve function and possibly mitigate the risk for development of osteoarthritis in patients with functionally deficient meniscus pathology, meniscal allograft transplantation (MAT) can be used to restore native joint biomechanics and increase knee joint longevity. This review explores the senior author's preferred bridge-in-slot technique and recently published long-term clinical and radiographic outcomes following MAT.
Recent literature demonstrates MAT to be a safe and largely successful procedure for patients with functional meniscus deficiency. A majority of patients reach established minimal clinically important difference (MCID) values. Graft survivorship is approximately 80% at 10 years, significantly delaying and in some cases, preventing the need for future joint reconstruction procedures in these young patients. Return to sport rates are over 70%, revealing meniscal allografts can withstand high impact activities. Cartilage damage at the time of MAT increases the risk for graft and clinical failure, though this may be mitigated with a concomitant cartilage restoration procedure. Meniscal allograft transplantation can provide a durable and effective long-term solution to meniscal deficiency in symptomatic patients who wish to decrease the risk of symptomatic progression and possibly further osteoarthritis and continue activities of daily life and sports with less pain and more function. By restoring more normal joint biomechanics, MAT can mitigate the potential need for future knee arthroplasty in this young active patient population.
为减轻功能不全的半月板病变患者的疼痛、改善功能并可能降低骨关节炎的发病风险,半月板同种异体移植(MAT)可用于恢复天然关节生物力学并延长膝关节寿命。本综述探讨了资深作者所青睐的槽内桥接技术以及MAT术后近期发表的长期临床和影像学结果。
近期文献表明,MAT对于功能性半月板缺损患者而言是一种安全且基本成功的手术。大多数患者达到已确定的最小临床重要差异(MCID)值。移植物10年生存率约为80%,显著延迟且在某些情况下可避免这些年轻患者未来进行关节重建手术。恢复运动率超过70%,表明半月板同种异体移植物能够承受高强度活动。MAT时的软骨损伤会增加移植物和临床失败的风险,不过可通过同时进行软骨修复手术来减轻这种风险。半月板同种异体移植可为有症状的患者提供持久有效的长期半月板缺损解决方案,这些患者希望降低症状进展以及可能进一步发生骨关节炎的风险,并能在疼痛减轻且功能增强的情况下继续进行日常生活和运动。通过恢复更正常的关节生物力学,MAT可减少这一年轻活跃患者群体未来进行膝关节置换术的潜在需求。