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Mid-Term Clinical and Radiological Outcomes of Lateral Meniscal Allograft Transplantation with Suture-Only Fixation Plus Capsulodesis
Journal of Knee Surgery ( IF 1.6 ) Pub Date : 2023-01-13 , DOI: 10.1055/a-1946-7079
Rodolfo Morales-Avalos 1, 2, 3 , Ángel Masferrer-Pino 1 , José Ramón Padilla-Medina 3 , Jorge Amestoy-Ramos 1 , Maximiliano Ibáñez 1 , Simone Perelli 1, 4 , Cristina Ariztegui-Andrade 5 , João Espregueira-Mendes 6, 7 , Joan Carles Monllau 1, 4
Affiliation  

Meniscal allograft transplantation (MAT) is an effective reconstructive procedure for treating a symptomatic postmeniscectomy syndrome. It consists of replacing the lost meniscal tissue aiming to improve the clinical outcomes and prevent progressive deterioration of the joint. The aim of this study was to evaluate meniscal graft survivorship and report on the radiographic (in terms of graft extrusion and joint space width and alignment) and the functional results through a midterm follow-up of lateral MAT performed with a soft tissue fixation technique after capsulodesis. In total, 23 patients who underwent lateral MAT as a single procedure were included. The Knee injury and Osteoarthritis Outcome Score, Lysholm, Tegner, and visual analog scale scales were used for patient assessment. Magnetic resonance imaging and a complete radiographic protocol were conducted to determine the degree of meniscal extrusion and the changes in the degree of osteoarthritis and coronal alignment. Assessments were performed after 2 and 7 years of follow-up. A significant improvement in all the scores, relative to preoperative values, was found after 7 years of follow-up. This improvement remained consistent throughout the first and second follow-up periods. A mean absolute extrusion of 2.2 mm ± 1.6 and an extrusion percentage of 28.0% ± 11.43 were found, with no significant differences throughout the follow-up periods. There was no statistically significant difference in terms of the frontal mechanical axis and joint space narrowing between the preoperative value and at the first and second follow-up periods. A survival rate of 85.7% was found after 7 years of follow-up. Capsulodesis results in a low degree of meniscal extrusion in isolated lateral MAT fixed with a suture-only technique, which is maintained after 7 years of follow-up, with a high graft survival index (>85%) and satisfactory results on the functional scales.



中文翻译:


仅缝合固定加关节囊固定术的外侧半月板同种异体移植的中期临床和放射学结果



同种异体半月板移植(MAT)是治疗有症状的半月板切除术后综合征的有效重建手术。它包括替换丢失的半月板组织,旨在改善临床结果并防止关节进行性恶化。本研究的目的是评估半月板移植物的存活率,并通过在术后使用软组织固定技术进行外侧 MAT 的中期随访,报告放射线照相(移植物挤压和关节间隙宽度和对齐)和功能结果。囊膜固定术。总共包括 23 名接受侧向 MAT 作为单一手术的患者。膝损伤和骨关节炎结果评分、Lysholm、Tegner 和视觉模拟量表用于患者评估。进行磁共振成像和完整的放射线照相方案以确定半月板挤压程度以及骨关节炎和冠状排列程度的变化。随访 2 年和 7 年后进行评估。经过 7 年的随访,发现所有评分相对于术前都有显着改善。这种改善在第一和第二个随访期间保持一致。平均绝对挤出量为 2.2 mm ± 1.6,挤出百分比为 28.0% ± 11.43,在整个随访期间没有显着差异。术前的额部机械轴和关节间隙狭窄程度与第一、第二次随访时的值之间没有统计学上的显着差异。 7年随访后发现生存率为85.7%。 采用仅缝合技术固定的孤立外侧 MAT 中,关节囊固定术可实现低程度的半月板挤压,并在​​ 7 年随访后维持,具有较高的移植物存活指数(>85%)和令人满意的功能评分结果。

更新日期:2023-01-14
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