Background:The outcomes of medial meniscal allograft transplantation (MMAT) combined with high tibial osteotomy (HTO) compared with isolated MMAT remain unclear.Purpose:To compare the clinical and radiological results of MMAT combined with HTO and isolated MMAT.Study Design:Cohort study; Level of evidence, 3.Methods:This retrospective study included 42 consecutive patients, who were divided into group M (isolated MMAT; n = 22) and group H (MMAT combined with HTO with a varus angle >3°; n = 20). Group differences in subjective knee scores, isokinetic muscle strength test, and radiological outcomes (Kellgren-Lawrence grade, mechanical axis, graft extrusion, graft status, and articular cartilage loss) were compared.Results:The mean follow-up period was 29.2 ± 4.9 months and 27.4 ± 5.3 months for groups M and H, respectively. The Lysholm score improved from 55.4 ± 9.5 to 81.3 ± 9.7 and from 52.6 ± 8.9 to 84.2 ± 10.2 in groups M and H, respectively (both P < .001). The International Knee Documentation Committee subjective score improved from 51.4 ± 10.3 to 79.6 ± 9.4 and from 49.3 ± 11.4 to 81.4 ± 8.3 in groups M and H, respectively (both P < .001). Both groups showed no significant differences in subjective knee scores and isokinetic extensor strength at the final follow-up. The rate of preoperative and postoperative high International Cartilage Regeneration & Joint Preservation Society grade (≥3) did not differ between the 2 groups. Group M showed greater coronal graft extrusion than did group H (3.3 ± 0.7 mm vs 2.7 ± 0.8 mm; P = .014); the rate of pathologic graft extrusion (≥3 mm) was not higher in group M (40.9%) than in group H (20%) with the number of patients available ( P = .143). Both groups showed no significant difference in the graft status. Graft tears were observed in 2 patients (9%) in group M and 1 patient (5%) in group H ( P = .607).Conclusion:Clinical scores significantly improved after isolated MMAT and MMAT combined with HTO compared with preoperative values, and their short-term outcomes were similar. Postoperative graft extrusion was greater in patients who underwent isolated MMAT, implying that active correction of varus alignment during MMAT may help in intra-articular biomechanics.

中文翻译：

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内侧半月板同种异体移植联合矫正手术的临床和放射学结果


背景：同种异体内侧半月板移植（MMAT）联合胫骨高位截骨术（HTO）与单独MMAT相比的结果仍不清楚。目的：比较MMAT联合HTO与单独MMAT的临床和影像学结果。研究设计：队列研究;证据级别，3。方法：这项回顾性研究包括 42 名连续患者，分为 M 组（孤立的 MMAT；n = 22）和 H 组（MMAT 联合 HTO，内翻角 >3°；n = 20） 。比较主观膝关节评分、等速肌力测试和放射学结果（Kellgren-Lawrence 分级、机械轴、移植物挤出、移植物状态和关节软骨损失）的组间差异。结果：平均随访时间为 29.2 ± 4.9 M 组和 H 组分别为 27.4 ± 5.3 个月和 27.4 ± 5.3 个月。 M 组和 H 组的 Lysholm 评分分别从 55.4 ± 9.5 提高到 81.3 ± 9.7，从 52.6 ± 8.9 提高到 84.2 ± 10.2（均 P < .001）。 M 组和 H 组的国际膝关节文献委员会主观评分分别从 51.4 ± 10.3 提高到 79.6 ± 9.4，从 49.3 ± 11.4 提高到 81.4 ± 8.3（均 P < .001）。最终随访时，两组主观膝关节评分和等速伸肌力量均无显着差异。术前和术后国际软骨再生与关节保护协会高等级（≥3）的发生率在两组之间没有差异。 M 组表现出比 H 组更大的冠状移植物挤出（3.3 ± 0.7 mm vs 2.7 ± 0.8 mm；P = .014）；就可用患者数量而言，M 组 (40.9%) 的病理性移植物脱出率 (≥3 mm) 并不高于 H 组 (20%) ( P = .143)。两组移植物状态均无显着差异。 M 组有 2 例患者（9%）出现移植物撕裂，H 组有 1 例患者（5%）出现移植物撕裂（ P = .607）。结论：单独 MMAT 和 MMAT 联合 HTO 后临床评分较术前显着改善，他们的短期结果相似。在接受单独 MMAT 的患者中，术后移植物挤压更大，这意味着 MMAT 期间主动矫正内翻对齐可能有助于关节内生物力学。