男性和女性在膝关节原发性骨软骨异体移植后的失败率和再手术率相当，但女性接受再手术的时间更早。

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-10-13 DOI:10.1002/ksa.12507

Allen A. Yazdi, Alexander C. Weissman, Kyle R. Wagner, Sarah A. Muth, Jared M. Rubin, Ron Gilat, Brian J. Cole

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引用次数: 0

摘要

目的：比较接受膝关节原发性骨软骨异体移植的男性和女性在术前疾病表现、失败和再手术方面的差异：方法：对2002年至2020年期间接受初级骨软骨同种异体移植手术的年龄≥18岁的患者进行回顾性研究，这些患者均由一名外科医生进行了至少2年的随访。研究人员收集了所有纳入患者的人口统计学、术前、术中和术后数据。然后根据患者报告的性别将其分为男性或女性两组。统计分析用于评估基线特征中与性别相关的差异，比较生存分析用于确定生存概率，回归分析用于确定与后续再次手术或失败相关的变量：在已确定的 437 名患者中，有 337 名患者（77.1% 的随访率，161 名男性，176 名女性）随访时间至少为 2 年。纳入患者的平均年龄为 31.3 ± 9.9 岁（范围为 18.0-55.9），体重指数为 26.7 ± 4.4（范围为 19.0-39.0），平均随访时间为 5.6 ± 2.6 年（范围为 2.0-16.3）。男性患者的体重指数（BMI）明显更高（p ≤ 0.01），股骨内侧髁的病变可能性更大（p = 0.041），股骨内侧髁（p ≤ 0.01）和股骨外侧髁（p ≤ 0.01）的病变面积更大。36.8%的患者（59名男性，65名女性）随后接受了再次手术。男性患者再次手术的平均时间为 3.5 ± 2.8 年（0.4-16.3 年），女性患者为 2.1 ± 1.9 年（0.1-13.5 年）。两组患者的再手术率（正常值）和无再手术生存率（正常值）无明显差异，但女性患者接受再手术的时间更早（P = 0.028）。63例（18.7%）患者随后出现移植失败（36例男性，27例女性）。两组患者在失败率、失败时间、失败后存活率或失败方式方面均无明显差异（均为 n.s.）：尽管在基线人口统计学和术中变量方面存在一些差异，但接受膝关节原发性骨软骨异体移植的男性和女性在失败率或再手术方面没有发现明显差异，只是女性接受再手术的时间更早：研究设计：回顾性队列比较研究：证据等级：III级。

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Men and women demonstrate comparable rates of failures and reoperations following primary osteochondral allograft transplantation of the knee, but women undergo reoperation sooner

Purpose

To compare the differences between men and women who receive primary osteochondral allograft transplantation of the knee with regard to preoperative disease presentation, failures and reoperations.

Methods

A retrospective review of patients ≥18 years old who underwent primary osteochondral allograft transplantation between 2002 and 2020 by a single surgeon with a minimum of 2-year follow-up was performed. Demographic, preoperative, intraoperative and postoperative data were collected for all included patients. Patients were then assigned to two groups, either male or female, based on their reported sex. Statistical analysis was performed to assess sex-related differences in baseline characteristics, comparative survival analysis for determining survival probabilities, and regression analysis for determining variables associated with subsequent reoperation or failure.

Results

Among the 437 patients that were identified, 337 patients (77.1% follow-up, 161 men, 176 women) with a minimum of 2-year follow-up were included in our study. The mean age of included patients was 31.3 ± 9.9 years (range, 18.0–55.9), with a BMI of 26.7 ± 4.4 (range, 19.0–39.0) and a mean follow-up of 5.6 ± 2.6 years (range, 2.0–16.3). Male patients had significantly higher body mass index (BMI) (p ≤ 0.01), were more likely to have lesions on the medial femoral condyle (p = 0.041), and had larger lesions at the medial femoral condyle (p ≤ 0.01) and lateral femoral condyle (p ≤ 0.01). 36.8% of patients experienced subsequent reoperation (59 male, 65 female). Mean time to reoperation was 3.5 ± 2.8 years (range, 0.4–16.3 years) in males and 2.1 ± 1.9 years (range, 0.1–13.5 years) in females. No significant difference was found between the two groups with regard to reoperation rates (n.s.) or survivability free from reoperation (n.s.), but females were found to undergo reoperation sooner (p = 0.028). Sixty-three (18.7%) patients experienced subsequent graft failure (36 male, 27 female). No significant difference was found between the two groups in terms of failure rates, time to failure, survivability free from failure, or mode of failure (n.s. for all).

Conclusions

Despite several differences in baseline demographics and intraoperative variables, no significant differences were found between men and women receiving primary osteochondral allograft transplantation of the knee with regard to failure or reoperation, with the exception that women underwent reoperation sooner.