Clinical Evaluation Of Arthroscopic-assisted Allograft Meniscal Transplantation:1-8 Years Follow-up Study

BackgroundWith the penetration of high and new technology in the medical field, meniscus injury diagnosis, treatment has made great progress. Meniscus injury of articular cartilage degeneration and osteoarthritis has become uncertain, how to treat the meniscus injury to avoid the occurrence of joint degeneration is still facing the scholars important topic. The surgical treatment of meniscus injury in clinical application is more extensive, but most scholars still used meniscectomy, trimming, suture techniques, however, there is still the occurrence of postoperative joint degeneration, so after meniscus injury treatment how to try to achieve the original physiological function of the meniscus, avoid the happening of the complications, is still a difficult problem in front of us.Meniscus transplantation can rebuild the meniscus, to restore the knee joint normal biomechanical environment, avoid meniscectomy conduction disturbance caused by load, delay of joint degeneration.The present study the reconstruction of the meniscus tissue engineering materials including meniscus implant, meniscus, heterogeneous organization, allograft meniscus and autologous tissue transplantation, etc. Meniscus implant can be made of ptfe, silicone resin and polylactic acid, its flexibility, creep has yet to reach the demands the meniscus and biological characteristics. The meniscus tissue engineering at present was still in the stage of experiment research. Heterogeneous organization including under the small intestinal mucosa tissue to induce the meniscus proved regeneration, but with the original meniscus on the morphology and mechanical properties. Autologous tissue including the patellar tendon, tendon and perichondrium have tried in the reconstruction of the meniscus, but its form and structure are difficult to match with meniscus. Allograft meniscus is considered to be the only at present but in clinical widely applied, the meniscus rebuilding of the most promising materials. Both at home and abroad studies have confirmed that the meniscal allograft transplantation(MAT) can alleviate the meniscus of knee joint pain symptoms after resection, improve joint function.For more than twenty years, scholars at home and abroad for meniscal allograft of storage and disinfection, matching and meniscus transplantation surgery technology to do a lot of research. At present, the MAT has obtained the satisfactory result of short-term, but long-term clinical effect, especially in the cartilage protection, prevent or slow down the occurrence of osteoarthritis(OA), morphological and histological changes of the meniscal allograft in the body, the impact on long-term knee joint function after transplantation, there is no standard, strict evidence-based medical evidence. This study is based on our previous MAT patients for 1-8 years clinical function evaluation and follow-up study. For the treatment of meniscus, especially MAT provides theoretical basis and clinical experience. ObjectiveThis topic mainly through to the usual meniscus transplantation cases evaluate clinical features and postoperative 1-8 years follow-up study, improve the effect of assessment of meniscus transplantation and surgery. MethodsFollow-up from December 2006 to December 2013 in our hospital 74 cases of MAT by telephone follow-up, successful cases for 56 cases. Follow-up the success rate of 75.7%.30 patients(53.6%) of men and women 26 cases(46.4%).Age 16 ~ 50 years old, the average of soil(32.11 32.11) years, function is through the use of the results of follow-up IKDC primary knee function score, Lysholm scale and Tegner sports scores, and visual analogue scale(VAS) pain assessment. On standard and X-ray imaging evaluation including joint clearance and magnetic resonance imaging in the evaluation. ResultsIKDC scores increased from 54.43 preoperatively to follow-up of 81.16(P < 0.05), Lysholm score increased from69.03 to 89.39(P < 0.05), the Tegner score increased from 3.91 preoperatively to 7.41(P < 0.05).Visual analog scale(VAS) score dropped significantly from 5.32 to 2.36(P < 0.05).Radiographic evaluation did not show any joint space narrow. Meniscus convex outside MAT is a common postoperative results. ConclusionsThe study shows that the average 70 months MAT can significantly increase the activity of the knee joint function, improve the pain, we observed a lot of meniscus outward from the MRI and shrinkage, but the outer convex of increase and the length of time and the knee joint function after surgery for MAT scores did not seem to matter.