{"title":"半腱肌或髌骨韧带自体移植物在半月板重建中的疼痛缓解和生活质量优于同种异体移植物：一项为期2年的前瞻性比较研究。","authors":"Maher Ghandour, Ayoosh Pareek, Shintaro Onishi, Christophe Jacquet, Jean Noel Argenson, Mathieu Ollivier","doi":"10.1002/ksa.12562","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare the 2-year clinical outcomes of meniscal reconstructions using allograft versus autograft tissue, with a focus on patient-reported outcomes, complication rates and surgical revision rates.</p><p><strong>Methods: </strong>This prospective comparative cohort study included 60 patients (ages 18-60 years) undergoing meniscal reconstruction. Patients were divided into an allograft group (n = 31) and an autograft group (n = 29; Hamstring tendon = 25 and patellar tendons = 4). Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), University of California, Los Angeles (UCLA) score and EuroQol-5D (EQ-5D) score. Surgical revision rates, reoperation rates and complication rates were recorded. Time-to-reoperation was analyzed using Kaplan-Meier survival curves and a Cox hazards model was used to identify predictors of time-to-reoperation/revision (failure).</p><p><strong>Results: </strong>At 2 years, the autograft group had higher KOOS pain scores (89.93 vs. 86.87, p = 0.002) and EQ-5D scores (0.884 vs. 0.802, p = 0.002) compared to the allograft group. There were no differences in KOOS sports, symptoms, activities of daily living or UCLA scores between the groups. The allograft group had a higher complication (relative risk [RR] = 2.34, 95% confidence interval [CI]: 0.49-11.13, p = 0.266), reoperation (RR = 1.87, 95% CI: 0.51-6.80, p = 0.329) and revision surgery rates (RR = 2.81, 95% CI: 0.31-25.48, p = 0.334), although not statistically significant. Cox modelling identified autograft as a significant predictor of reduced reoperation risk (hazards ratio = 0.057, 95% CI: 0.004-0.036, p = 0.036), with higher preoperative KOOS pain and sports scores also associated with reduced reoperation risk.</p><p><strong>Conclusion: </strong>These preliminary results show that meniscal reconstruction using autograft tissue is associated with better clinical outcomes in terms of pain relief and quality of life, as well as lower reoperation and complication rates, compared to allograft tissue. However, these observations need to be validated by well-powered research.</p><p><strong>Level of evidence: </strong>Level III prospective.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Superior pain relief and quality of life with autografts using semitendinosus or patellar ligament compared to allografts in meniscal reconstruction: A 2-year prospective comparative study.\",\"authors\":\"Maher Ghandour, Ayoosh Pareek, Shintaro Onishi, Christophe Jacquet, Jean Noel Argenson, Mathieu Ollivier\",\"doi\":\"10.1002/ksa.12562\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aims to compare the 2-year clinical outcomes of meniscal reconstructions using allograft versus autograft tissue, with a focus on patient-reported outcomes, complication rates and surgical revision rates.</p><p><strong>Methods: </strong>This prospective comparative cohort study included 60 patients (ages 18-60 years) undergoing meniscal reconstruction. Patients were divided into an allograft group (n = 31) and an autograft group (n = 29; Hamstring tendon = 25 and patellar tendons = 4). Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), University of California, Los Angeles (UCLA) score and EuroQol-5D (EQ-5D) score. Surgical revision rates, reoperation rates and complication rates were recorded. Time-to-reoperation was analyzed using Kaplan-Meier survival curves and a Cox hazards model was used to identify predictors of time-to-reoperation/revision (failure).</p><p><strong>Results: </strong>At 2 years, the autograft group had higher KOOS pain scores (89.93 vs. 86.87, p = 0.002) and EQ-5D scores (0.884 vs. 0.802, p = 0.002) compared to the allograft group. There were no differences in KOOS sports, symptoms, activities of daily living or UCLA scores between the groups. The allograft group had a higher complication (relative risk [RR] = 2.34, 95% confidence interval [CI]: 0.49-11.13, p = 0.266), reoperation (RR = 1.87, 95% CI: 0.51-6.80, p = 0.329) and revision surgery rates (RR = 2.81, 95% CI: 0.31-25.48, p = 0.334), although not statistically significant. Cox modelling identified autograft as a significant predictor of reduced reoperation risk (hazards ratio = 0.057, 95% CI: 0.004-0.036, p = 0.036), with higher preoperative KOOS pain and sports scores also associated with reduced reoperation risk.</p><p><strong>Conclusion: </strong>These preliminary results show that meniscal reconstruction using autograft tissue is associated with better clinical outcomes in terms of pain relief and quality of life, as well as lower reoperation and complication rates, compared to allograft tissue. However, these observations need to be validated by well-powered research.</p><p><strong>Level of evidence: </strong>Level III prospective.</p>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-12-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12562\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12562","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Superior pain relief and quality of life with autografts using semitendinosus or patellar ligament compared to allografts in meniscal reconstruction: A 2-year prospective comparative study.
Purpose: This study aims to compare the 2-year clinical outcomes of meniscal reconstructions using allograft versus autograft tissue, with a focus on patient-reported outcomes, complication rates and surgical revision rates.
Methods: This prospective comparative cohort study included 60 patients (ages 18-60 years) undergoing meniscal reconstruction. Patients were divided into an allograft group (n = 31) and an autograft group (n = 29; Hamstring tendon = 25 and patellar tendons = 4). Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), University of California, Los Angeles (UCLA) score and EuroQol-5D (EQ-5D) score. Surgical revision rates, reoperation rates and complication rates were recorded. Time-to-reoperation was analyzed using Kaplan-Meier survival curves and a Cox hazards model was used to identify predictors of time-to-reoperation/revision (failure).
Results: At 2 years, the autograft group had higher KOOS pain scores (89.93 vs. 86.87, p = 0.002) and EQ-5D scores (0.884 vs. 0.802, p = 0.002) compared to the allograft group. There were no differences in KOOS sports, symptoms, activities of daily living or UCLA scores between the groups. The allograft group had a higher complication (relative risk [RR] = 2.34, 95% confidence interval [CI]: 0.49-11.13, p = 0.266), reoperation (RR = 1.87, 95% CI: 0.51-6.80, p = 0.329) and revision surgery rates (RR = 2.81, 95% CI: 0.31-25.48, p = 0.334), although not statistically significant. Cox modelling identified autograft as a significant predictor of reduced reoperation risk (hazards ratio = 0.057, 95% CI: 0.004-0.036, p = 0.036), with higher preoperative KOOS pain and sports scores also associated with reduced reoperation risk.
Conclusion: These preliminary results show that meniscal reconstruction using autograft tissue is associated with better clinical outcomes in terms of pain relief and quality of life, as well as lower reoperation and complication rates, compared to allograft tissue. However, these observations need to be validated by well-powered research.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
