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合成内侧半月板植入物显示出较高的再次手术率:保留植入物或需要更换植入物的患者在半月板切除术后膝关节疼痛和临床功能方面有所改善。

Synthetic medial meniscus implant demonstrates high reoperation rates: Patients who retain implant or require implant exchange show improvement in post meniscectomy knee pain and clinical function.

作者信息

Carter Thomas, Jones Deryk, Hacker Scott, Gersoff Wayne

机构信息

Banner- University of Arizona, Phoenix Arizona, U.S.A..

Ochsner Sports Medicine Institute Jefferson, Los Angeles, U.S.A.

出版信息

Arthroscopy. 2025 Jul;41(7):2449-2458. doi: 10.1016/j.arthro.2024.10.033. Epub 2024 Nov 4.

Abstract

PURPOSE

To evaluate the clinical outcomes in the use of a synthetic medial meniscus implant in patients symptomatic after medial meniscectomy and not responsive to nonoperative treatment.

METHODS

This single-arm, multicenter, prospective study enrolled subjects between ages 30 and 75 with postmeniscectomy pain. Changes from baseline to 24 months were measured in the pain subscale of the knee injury and osteoarthritis outcome score (KOOS) and in KOOS overall (average of all 5 subscales) in patients that had received a medial meniscus implant. Success was a 20-point improvement at 24 months, and reoperation rates and implant failures were recorded. Visual Analog Scale, International Knee Documentation Committee, and Western Ontario Meniscal Evaluation Tool scores were also measured.

RESULTS

Of the 115 treated patients, 3 (2.6%) were either lost to follow-up or missed the 24-month visit, 48 (43%) patients had at least 1 subsequent surgery, and 12 (10.7%) had the implant permanently removed. Of the remaining 100 patients, the mean KOOS pain improved 28.4 points at 24 months (P < .001), and the mean KOOS overall improved 28.3 points (P < .001). Of the subjects, 76% had mean scores for KOOS pain above the minimal clinically important difference threshold, and 72% of subjects met or exceeded this threshold for KOOS overall. There were 29 patients (25.9%) who underwent implant exchange. The 24-month clinical outcomes were similar between subjects who had an implant exchange and patients who did not have any subsequent implant procedure (P < .2).

CONCLUSIONS

The synthetic medial meniscus implant shows high reoperation and failure rates. Patients who retained the implant or required implant exchange showed improved pain and function.

摘要

目的

评估在半月板切除术术后出现症状且非手术治疗无效的患者中使用合成内侧半月板植入物的临床疗效。

方法

这项单臂、多中心、前瞻性研究纳入了年龄在30至75岁之间有半月板切除术后疼痛的受试者。对接受内侧半月板植入物的患者,测量从基线到24个月时膝关节损伤和骨关节炎疗效评分(KOOS)疼痛子量表以及KOOS总分(所有5个子量表的平均值)的变化。成功定义为在24个月时改善20分,并记录再次手术率和植入物失败情况。还测量了视觉模拟量表、国际膝关节文献委员会和西安大略半月板评估工具评分。

结果

在115例接受治疗的患者中,3例(2.6%)失访或未参加24个月的随访,48例(43%)患者至少接受了1次后续手术,12例(10.7%)患者永久性取出了植入物。在其余100例患者中,KOOS疼痛平均分在24个月时改善了28.4分(P <.001),KOOS总分平均分改善了28.3分(P <.001)。在受试者中,76%的KOOS疼痛平均分高于最小临床重要差异阈值,72%的受试者KOOS总分达到或超过该阈值。有29例患者(25.9%)进行了植入物更换。进行植入物更换的受试者与未进行任何后续植入手术的患者在24个月时的临床疗效相似(P <.2)。

结论

合成内侧半月板植入物显示出较高的再次手术率和失败率。保留植入物或需要更换植入物的患者疼痛和功能得到改善。

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