Cook James L, Stannard James P, Rucinski Kylee J, Nuelle Clayton W, Crecelius Cory R, Cook Cristi R, Ma Richard
Thompson Laboratory for Regenerative Orthopaedics, MU Joint Preservation Center, Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri.
J Knee Surg. 2025 Jan;38(1):35-42. doi: 10.1055/a-2389-9001. Epub 2024 Aug 16.
Based on recent evidence-based advances in meniscus allograft transplantation (MAT), fresh (viable) meniscus allografts have potential for mitigating key risk factors associated with MAT failure, and preclinical and clinical data have verified the safety of fresh meniscus allografts as well as possible efficacy advantages compared with fresh-frozen meniscus allografts. The objective of this study was to prospectively assess clinical outcomes for the initial cohort of patients undergoing MAT using fresh meniscus allografts at our center. Patients who were prospectively enrolled in a dedicated registry were included for analyses when they had undergone primary MAT using a fresh meniscus allograft for treatment of medial and/or lateral meniscus deficiency with at least 1-year follow-up data recorded. Forty-five patients with a mean final follow-up of 47.8 months (range = 12-90 months) were analyzed. The mean patient age was 30.7 years (range = 15-60 years), mean body mass index (BMI) was 29.7 kg/m (range = 19-48 kg/m), and 14 patients (31%) were females. In total, 28 medial, 13 lateral, and 4 combined medial and lateral MATs with 23 concurrent ligament reconstructions and 2 concurrent osteotomies were included. No local or systemic adverse events or complications related to MAT were reported for any patient in the study. Treatment success rate for all patients combined was 91.1% with three patients requiring MAT revision and one patient requiring arthroplasty. Treatment failures occurred 8 to 34 months after MAT and all involved the medial meniscus. None of the variables assessed were significantly different between treatment success and treatment failure cohorts. Taken together, the data suggest that the use of fresh (viable) meniscus allografts can be considered a safe and effective option for medial and lateral MAT. When transplanted using double bone plug suspensory fixation with meniscotibial ligament reconstruction, fresh MATs were associated with a 91% success rate, absence of local or systemic adverse events or complications, and statistically significant and clinically meaningful improvements in patient-reported measures of pain and function at a mean of 4 years postoperatively.
基于近期半月板同种异体移植（MAT）循证医学的进展，新鲜（有活力的）半月板同种异体移植物有潜力减轻与MAT失败相关的关键风险因素，并且临床前和临床数据已证实新鲜半月板同种异体移植物的安全性以及与新鲜冷冻半月板同种异体移植物相比可能存在的疗效优势。本研究的目的是前瞻性评估在我们中心接受使用新鲜半月板同种异体移植物进行MAT的首批患者队列的临床结局。前瞻性纳入专门登记处的患者，当其使用新鲜半月板同种异体移植物进行初次MAT以治疗内侧和/或外侧半月板缺损且记录了至少1年的随访数据时，纳入分析。分析了45例患者，平均最终随访时间为47.8个月（范围 = 12 - 90个月）。患者平均年龄为30.7岁（范围 = 15 - 60岁），平均体重指数（BMI）为29.7kg/m²（范围 = 19 - 48kg/m²），14例患者（31%）为女性。总共包括28例内侧MAT、13例外侧MAT以及4例内侧和外侧联合MAT，其中23例同时进行了韧带重建，2例同时进行了截骨术。研究中没有任何患者报告与MAT相关的局部或全身不良事件或并发症。所有患者的综合治疗成功率为91.1%，3例患者需要进行MAT翻修，1例患者需要进行关节成形术。治疗失败发生在MAT后8至34个月，均累及内侧半月板。治疗成功和治疗失败队列之间评估的变量均无显著差异。总体而言，数据表明使用新鲜（有活力的）半月板同种异体移植物可被视为内侧和外侧MAT的一种安全有效的选择。当采用双骨栓悬吊固定联合半月板胫骨韧带重建进行移植时，新鲜MAT的成功率为91%，无局部或全身不良事件或并发症，并且在术后平均4年时患者报告的疼痛和功能测量指标有统计学显著且具有临床意义的改善。
