半月板同种异体移植在移植物中度失败率下维持10年以上功能与活动：系统综述与Meta分析
简介
该研究系统评价了半月板同种异体移植术（MAT）治疗症状性半月板缺损的长期（≥10年）临床结局。共纳入20项研究（1096例患者，平均随访151.6个月）。关键发现：患者报告结局指标（Lysholm、KOOS、IKDC、Tegner、VAS）从术前至末次随访持续改善并维持；客观失败率（需转换为关节置换）为17%（95% CI 15%-21%），主观失败率（Ly…
英文摘要
PURPOSE: To evaluate long-term (≥10-year) clinical and patient-reported outcomes, return to sport, graft survival, and complication rates following meniscus allograft transplantation (MAT) in patients with symptomatic meniscal deficiency. METHODS: A systematic review was conducted in accordance with PRISMA guidelines using MEDLINE, EMBASE, and PubMed from inception to September 7, 2025. Studies reporting clinical outcomes or patient reported outcome measures (PROMs) (e.g., Lysholm, Knee Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), Tegner, Visual Analog Scale (VAS), return to sport, and/or graft failure after MAT with ≥10-year follow-up were included. Meta-analyses were performed for long-term PROMs and objective failure rates using random-effects models, with pooled estimates reported alongside 95% confidence intervals (CIs). Heterogeneity was quantified using the I2 statistic. RESULTS: Twenty studies met inclusion criteria, comprising six level III and fourteen level IV studies. Across studies consisting of 1,096 patients at mean follow-up time of 151.6 ± 38.5 months, PROMs consistently improved from preoperative to final follow-up with maintained improvements. Fifteen studies contributed to the meta-analysis of objective failure, yielding a pooled failure rate of 31% (95% CI, 27-34%; I2 = 80%), with nine studies reported failure defined by conversion to arthroplasty (total or unicompartmental knee arthroplasty), with rates ranging from 2% to 25% and a pooled arthroplasty rate of 17% (95% CI, 15.0%-21.0%; I2 = 59%). Four studies reported subjective failure defined as Lysholm score <65, with reported rates ranging from 3% to 37% and a pooled subjective failure rate of 22% (95% CI, 15.0%-30.0%; I2 = 0%). CONCLUSION: Meniscal allograft transplantation demonstrates sustained improvements in pain, function, and activity levels at long-term follow-up in patients with symptomatic meniscal deficiency. However, the overall pooled failure rate of 31% highlights the need for careful patient selection and appropriate counselling regarding expected outcomes. The consistent direction of results across studies supports MAT as a valuable joint-preserving intervention for meniscus-deficient knees in patients.