平均随访13年，超声评估的半月板突出与内外侧半月板同种异体移植术后膝关节功能或关节退变影像学征象不相关
简介
对35例接受内侧或外侧半月板同种异体移植术（MAT）且随访至少5年的患者（平均随访13.3±6.7年），在仰卧、双足站立及单足站立位用超声测量移植侧与对侧半月板的挤出横截面积（CSA）和挤出距离，并评估关节间隙宽度（JSW）、Kellgren-Lawrence（KL）分级及标准化IKDC主观膝关节量表（IKDC SKF）。平均随访时，MAT侧半月板挤出CSA…
英文摘要
PURPOSE: The aim of this study was to assess meniscus extrusion using ultrasound after meniscus allograft transplantation (MAT) and its association with clinical outcomes. METHODS: Patients who underwent medial or lateral MAT with a minimum 5-year follow-up were included. Exclusion criteria included bilateral MAT. Meniscus extrusion cross-sectional area (CSA) and extrusion distance, for the index and contralateral meniscus, in supine position, bipodal and unipodal stance were measured using ultrasound. Joint space width (JSW) and Kellgren and Lawrence (KL) grade were assessed on radiographs. The International Knee Documentation Committee Subjective Knee Form (IKDC SKF) was collected to assess clinical outcomes. Significance was set at p < 0.05. Friedman and analysis of variance tests were used to compare meniscus extrusion across weight-bearing conditions. Between MAT groups, Mann-Whitney U test and independent-samples t test were performed. Multiple regression assessed associations between meniscus extrusion and (1) standardized IKDC-SKF, (2) JSW and (3) KL grade. RESULTS: Thirty-five patients (average age at MAT 29 ± 10 years; 46% females) were assessed at a mean follow-up of 13.3 ± 6.7 years. Meniscus extrusion CSA of the MAT meniscus, assessed at the latest follow-up, was significantly greater than that of the opposite meniscus (supine: 43.2 vs. 20.2; bipodal: 46.2 vs. 22.7; unipodal: 46.6 vs. 23.8 mm2, p < 0.05). Meniscus extrusion CSA and meniscus extrusion distance were significantly greater in the medial MAT group compared to the lateral MAT group (p < 0.05). No significant associations were found between meniscus extrusion CSA and standardized IKDC SKF, KL grade and JSW at final follow-up (p > 0.05). CONCLUSION: Medial MAT resulted in greater meniscus extrusion than lateral MAT in supine position, unipodal and bipodal stance. Meniscus extrusion was not significantly associated with clinical outcomes in this cohort and should not be considered a surrogate marker for clinical outcomes after MAT; rather, it may be better interpreted as a surrogate marker of biomechanical alterations associated with the risk of structural joint degeneration. LEVEL OF EVIDENCE: Level III.