关节镜辅助下前交叉韧带重建和内侧半月板同种异体移植物移植术后至少12个月的再手术率高,但临床结果可接受。

IF 4.1 Q1 ORTHOPEDICS
Dhruv S Shankar, Kinjal D Vasavada, Amanda Avila, Brittany DeClouette, Hadi Aziz, Eric J Strauss, Michael J Alaia, Laith M Jazrawi, Guillem Gonzalez-Lomas, Kirk A Campbell
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引用次数: 4

摘要

背景:单期内侧半月板同种异体移植(MAT)合并前交叉韧带重建(ACLR)是治疗年轻患者膝关节疼痛和不稳定的技术挑战,但临床和功能结果数据很少。本研究的目的是评估合并ACLR和内源性MAT后的手术和患者报告的结果。方法:我们对2010年至2021年在我院接受内源性MAT合并原发性或改进性ACLR的患者进行了回顾性病例系列,并进行了至少12个月的随访。评估并发症、再手术、视觉模拟量表(VAS)疼痛、满意度、Lysholm评分、重返运动和重返工作结果。患者报告结果测量信息系统(PROMIS)疼痛干扰、疼痛强度和身体功能评分用于测量患者相对于美国人群的功能状态。p值结果:该队列包括16例个体患者的17个膝关节。该队列以男性为主(82.4%),平均年龄31.9岁(范围19-49岁),平均体重指数(BMI) 27.9 kg/m2(范围22.5-53.3 kg/m2)。平均随访时间56.8个月(13 ~ 106个月)。大多数患者接受ACLR翻修(64.7%)。1年再手术率高(23.5%),其中2例(11.8%)撕裂半月板移植物。患者报告的结果显示VAS疼痛低(平均2.2),满意度高(平均77.9%),Lysholm评分公平(平均81.1)。复工率高(92.9%),复工率低(42.9%)。术后PROMIS评分与全国平均水平相当或更高,并与患者满意度显著相关(p结论:合并ACLR和MAT手术与良好的膝关节疼痛和功能预后以及术后高重返工作率相关,尽管1年再手术率高,重返运动率低。证据等级:四级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Acceptable clinical outcomes despite high reoperation rate at minimum 12-month follow-up after concomitant arthroscopically assisted anterior cruciate ligament reconstruction and medial meniscal allograft transplantation.

Acceptable clinical outcomes despite high reoperation rate at minimum 12-month follow-up after concomitant arthroscopically assisted anterior cruciate ligament reconstruction and medial meniscal allograft transplantation.

Acceptable clinical outcomes despite high reoperation rate at minimum 12-month follow-up after concomitant arthroscopically assisted anterior cruciate ligament reconstruction and medial meniscal allograft transplantation.

Background: Single-stage medial meniscus allograft transplantation (MAT) with concomitant anterior cruciate ligament reconstruction (ACLR) is a technically challenging procedure for management of knee pain and instability in younger patients, but clinical and functional outcomes data are sparse. The purpose of this study was to assess surgical and patient-reported outcomes following concomitant ACLR and medial MAT.

Methods: We conducted a retrospective case series of patients who underwent medial MAT with concomitant primary or revision ACLR at our institution from 2010 to 2021 and had minimum 12-month follow-up. Complications, reoperations, visual analog scale (VAS) pain, satisfaction, Lysholm score, return to sport, and return to work outcomes were assessed. Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference, Pain Intensity, and Physical Function Scores were used to measure patients' functional status relative to the US population. P-values < 0.05 were considered significant.

Results: The cohort consisted of 17 knees of 16 individual patients. The cohort was majority male (82.4%) with mean age of 31.9 years (range 19-49 years) and mean body mass index (BMI) of 27.9 kg/m2 (range 22.5-53.3 kg/m2). Mean follow-up time was 56.8 months (range 13-106 months). Most patients underwent revision ACLR (64.7%). The 1-year reoperation rate was high (23.5%), with two patients (11.8%) tearing their meniscus graft. Patient-reported outcomes indicated low VAS pain (mean 2.2), high satisfaction (mean 77.9%), and fair Lysholm score (mean 81.1). Return to work rate was high (92.9%), while return to sport rate was low (42.9%). Postoperative PROMIS scores were comparable or superior to the national average and correlated significantly with patient satisfaction (p < 0.05).

Conclusions: The concomitant ACLR and MAT procedure is associated with excellent knee pain and functional outcomes and high rate of return to work after surgery, though the 1-year reoperation rate is high and rate of return to sport is low.

Level of evidence: IV.

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