Midterm follow-up of meniscal allograft transplantation:61 cases report

目的：探讨同种异体半月板移植手术（ MAT）的中期疗效。方法北京大学深圳医院运动医学科自2007年1月至2013年12月共进行了73例MAT手术，排除了术后时间不到半年及失访的患者，共有61例（65侧）患者获得半年以上随访并纳入研究。平均随访时间31.0个月（6～80个月），平均年龄32.3岁。外侧半月板移植56例，内侧半月板移植9例；合并前交叉韧带损伤13例；同时行内、外侧半月板移植3例。使用视觉模拟评分（ VAS）、国际膝关节文献委员会评分（ IKDC）、Lysholm评分、Tegner活动评分、磁共振（ MRI）进行术前评估和术后随访，资料采用配对t检验进行对比。结果患者术后随访时在VAS疼痛评分、IKDC评分、Lysholm评分改善程度方面差异有统计学意义（P＜0.05）；关节活动度、Tegner评分差异无统计学意义（P＞0.05）。询问患者如果再次出现相同病情是否愿意接受此手术治疗，42例（68.9％）表示愿意接受手术，15例（24.6％）表示“考虑”，4例（6.5％）拒绝接受此手术。 MRI随访示移植物均与关节囊愈合。结论半月板移植物可以与关节囊达到满意愈合，MAT手术可以有效缓解半月板缺损患者的疼痛和改善膝关节功能，是治疗半月板缺失后出现早期临床症状患者的有效手段。Objective To investigate the midterm clinical results of arthroscopic meniscal allograft transplantation( MAT).Methods From January 2007 to December 2013, 73 consecutive patients underwent MAT in the department of sports medicine ,Peking University Shenzhen Hospital ,and 61 patients (36 men and 25 women) with a mean age of 32.3 years were followed up for more than six months and were enrolled in this study .The mean followe-up time was 31.0 months ( 6 -80 months ); 56 cases underwent lateral MAT , nine medial MAT; 13 cases combined ACL injury .There were three patients underwent the lateral MAT combined medial MAT at the same time .All the patients were evaluated at the follow-up by the range of the motion (ROM),international knee documentation committee (IKDC)score, Lysholm score,Tegner score,visual analogue scale (VAS) for pain scores and MRI.Results The mean results for VAS, IKDC score, Lysholm score were significant better than the data of preoperation ( P <0.05),while there was no significant difference in the ROM and Teger score (P>0.05).All the menisci grew union to the capsule .Forty-two (68.9%) patients prefered to take another MAT if there was a need . Conclusion Meniscal allograft transplantation resulted in significant symptomatic and functional improvement ,which is an effective treatment for the patients who undergo meniscectomy .深圳市科创委重点课题中国科技核心期刊(ISTIC)115-191