4例同种异体半月板移植术后中期随访报告

目的探讨同种异体半月板移植术后中期的临床效果。方法2005年6～7月，4例半月板切除术后患者接受关节镜辅助下的同种异体半月板移植。男3例，女1例。年龄分别21、27、35、38岁。3例内侧半月板移植，1例外侧半月板移植。随访内容包括症状及体征，术前及随访时的IKDC、Lysholm、Tegner评分。随访通过膝关节正侧位、双膝持重位及双下肢全长X线检查比较患侧及健侧关节间隙和力线改变，评估膝关节退变情况，通过MRI检查评估移植半月板位置及信号改变。其中1例接受二次关节镜探查。结果随访时间44～45个月。4例均无关节疼痛、肿胀等，关节活动度正常，IKDC、Lysholm及Tegner评分分别为84．75±2．63、91．50±4．43及7．00±0．82，术前为60．50±14．06、69．25±22．04及4．00±0．82。X线提示1例关节间隙较健侧狭窄2mm，其余正常，力线均正常。MRI提示3例内侧半月板体部均有轻度外凸，体部及后角有Ⅱ～Ⅲ度信号。1例二次关节镜探查提示移植半月板形态及张力正常。结论同种异体半月板移植术后中期临床效果良好，关节无明显退变，MRI对评估移植半月板具有重要价值。

Mid-term Follow-up of Meniscus Allograft Transplantation: Report of 4 Cases

Objective To evaluate the mid-term （44 months） outcomes of meniscus allografi transplantation in four patients. Methods Between June and July 2005, four patients （3 medial and 1 lateral; 3 men and 1 women; aged 21, 27, 35, 38 years） underwent arthroscopy-assisted meniscus allograft transplantation in our hospital. The clinical outcome of the patients was evaluated by assessing the symptoms and signs, IKDC, Lysholm, and Tegner scores and examining the anteroposterior and lateral radiographs of the transplanted knee, weight-bearing radiographs of the both knees, anteroposterior radiographs of the lower extremities as well as magnetic resonance imaging （MRI）. One patient underwent second-look arthroscopy. Results The follow-up time was 44 -45 months. During the period, all the patients showed a normal motion range of the knee without pain or effusion of the knee joints. The mean IKDC, Lysholm, and Tegner scores of the patients were 84.75 ±2.63, 91.50±4.43 and 7.00 ±0.82 respectively, which were significantly higher than those detected before the operation （ 60.50 ± 14.06, 69.25±22.04 and 4.00 ± 0.82 ）. The radiological results revealed no obvious degeneration or alignment changes though a 2-mm narrowing was shown in one of the patients. MRI showed mild extrusion for the body of the transplanted medial menisci and Ⅱto Ⅲ stage signal for the body and the posterior horn. Almost normal performance and tension of the transplanted meniscus was shown by arthroseopy. Conclusions Meniscus allograft transplantation shows good outcomes in mid-term follow-up. MRI is valuable for evaluating the implanted meniscus.