单纯缝线固定半月板同种异体移植物的再手术率高于骨栓或骨桥槽式固定技术
简介
该回顾性研究比较了139例半月板同种异体移植术（MAT）中三种固定方式（骨栓、骨桥-槽及单纯缝线）的再手术率。结果显示，单纯缝线固定组的半月板特异性再手术率（31.3%）显著高于骨桥-槽（8.9%）和骨栓（10.9%）固定组，再手术以半月板切除和半月板修复为主。临床提示应优先选择骨栓或骨桥-槽固定以降低翻修风险。
英文摘要
PURPOSE: To compare meniscus-specific reoperation rates among various meniscal allograft transplantation (MAT) fixation techniques including bone plug, bone bridge-in-slot, and suture-only fixation. METHODS: A retrospective review was conducted of patients who underwent MAT at a single academic institution between 2011 and 2023. Patients were included if they had documented fixation technique and a minimum of 1-year follow-up. Demographics, fixation techniques (bone plug, bone bridge-in-slot, and suture-only), and subsequent ipsilateral knee surgeries were recorded. Statistical analyses assessed the influence of fixation techniques and other factors on meniscus-specific reoperation rates defined as subsequent ipsilateral meniscectomy, meniscus repair, revision MAT, or knee arthroplasty. RESULTS: The study included 139 patients (54% male patients; mean age: 29.4 ± 10.0 years; body mass index: 27.3 ± 5.6) with a mean follow-up of 6.6 ± 3.1 years. Lateral compartment MAT was performed in 51.1% of cases. Patients undergoing suture-only fixation had significantly higher meniscus-specific reoperation rates (15/48, 31.3%) compared with bone bridge-in-slot (4/45, 8.9%) and bone plug (5/46, 10.9%) fixation (P = .006). Meniscectomy (15/35, 42.9%) and meniscal repair (7/35, 20.0%) were the most common reoperations. Other reoperations included 2 total knee arthroplasties within the suture-only cohort and a single MAT revision in the bone bridge-in-slot cohort. CONCLUSIONS: This study reveals that MAT using suture-only fixation exhibits significantly higher reoperation rates than bone plug and bone bridge-in-slot techniques, with meniscectomy and meniscal repair representing the predominant subsequent surgeries. LEVEL OF EVIDENCE: Level III, retrospective comparative study.