Background:

Proper anatomic restoration is an important consideration for meniscal allograft transplantation (MAT), even with the different anatomica characteristics between the medial meniscus and lateral meniscus.

Purpose/Hypothesis:

The purpose of this study was to assess the accuracy of anatomic restoration in medial and lateral MAT (MMAT and LMAT) procedures and to compare their outcomes. We hypothesized that (1) the anatomic differences between the medial and lateral menisci will mean a less accurate anatomic restoration for MMAT and (2) clinical outcomes after MMAT will be inferior compared with LMAT.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We retrospectively evaluated 20 patients who underwent MMAT using the bone plug technique and 21 patients who underwent LMAT using the keyhole technique at a single institution from July 2014 to June 2019. Demographic data, previous surgeries, and concomitant procedures were recorded, as were lower limb alignment and osteoarthritis grade on radiographs. Using preoperative and follow-up magnetic resonance imaging, the meniscal position, rotation, extrusion, and intrameniscal signal intensity were evaluated. Clinical outcomes were evaluated using the International Knee Documentation Committee and Lysholm scores.

Results:

The mean follow-up was 41.15 ± 18.86 and 45.43 ± 21.32 months for the MMAT and LMAT patients, respectively. Concomitant procedures were performed in 90% of MMATs and 15% of LMATs. There was no significant difference between the native and postoperative root positions after LMAT; however, for MMAT, the position of the anterior root was located significantly posteriorly (P = .002) and medially (P = .007) compared with preoperatively. In addition, the allograft medial meniscus was restored in a more internally rotated position (P = .029). MMATs also exhibited significantly increased meniscal extrusion compared with LMATs (posterior horn, P < .001; midbody, P = .027; anterior horn, P = .006). However, there was no significant difference between the 2 groups at final follow-up in intrameniscal signal intensity or clinical scores.

Conclusion:

LMAT showed higher accuracy than MMAT in restoring meniscal position and rotation, and there was less meniscal extrusion. However, clinical scores improved after both LMAT and MMAT compared with preoperative values, and midterm clinical outcomes were similar. The small anatomical errors seen in the MMAT technique were not clinically relevant at midterm follow-up.

中文翻译：

---

内侧和外侧半月板同种异体移植之间的解剖恢复和临床结果的评估

背景：

适当的解剖修复是半月板同种异体移植 (MAT) 的重要考虑因素，即使内侧半月板和外侧半月板之间的解剖学特征不同。

目的/假设：

本研究的目的是评估内侧和外侧 MAT（MMAT 和 LMAT）程序中解剖修复的准确性并比较它们的结果。我们假设（1）内侧和外侧半月板之间的解剖差异将意味着 MMAT 的解剖修复不太准确，（2）与 LMAT 相比，MMAT 后的临床结果将较差。

学习规划：

队列研究；证据水平，3。

方法：

我们回顾性评估了 2014 年 7 月至 2019 年 6 月在单一机构中使用骨栓技术接受 MMAT 的 20 名患者和使用锁孔技术接受 LMAT 的 21 名患者。记录了人口统计学数据、既往手术和伴随手术以及下肢射线照片上的对齐和骨关节炎等级。使用术前和随访磁共振成像，评估半月板位置、旋转、挤压和半月板内信号强度。使用国际膝关节文献委员会和 Lysholm 评分评估临床结果。

结果：

MMAT 和 LMAT 患者的平均随访时间分别为 41.15 ± 18.86 和 45.43 ± 21.32 个月。90% 的 MMAT 和 15% 的 LMAT 进行了伴随程序。LMAT后自然根位与术后根位无显着差异；然而，对于 MMAT，与术前相比，前牙根的位置显着向后 ( P = .002) 和内侧 ( P = .007)。此外，同种异体移植内侧半月板恢复到更内旋的位置（P = .029）。与 LMAT 相比，MMAT 还表现出显着增加的半月板挤压（后角，P < .001；中体，P = .027；前角，P= .006)。然而，在最终随访时，两组在半月板内信号强度或临床评分方面没有显着差异。

结论：

LMAT在恢复半月板位置和旋转方面表现出比MMAT更高的准确性，并且半月板挤压较少。然而，与术前相比，LMAT 和 MMAT 后的临床评分均有所改善，中期临床结果相似。MMAT 技术中出现的小的解剖错误在中期随访中没有临床相关性。