Background:Few studies have compared the characteristics of meniscal allograft tears between medial and lateral meniscal allograft transplantation (MAT) using bone fixation.Purpose:To investigate the prevalence, location, and patterns of allograft tears after MAT with the bone fixation technique and compare tear patterns between medial and lateral compartments according to the time elapsed after surgery.Study Design:Cohort study; Level of evidence, 3.Methods:The charts of consecutive patients who underwent primary medial or lateral MAT between December 1996 and June 2019 were retrospectively reviewed. The location, pattern, and postoperative periods during which allograft tears occurred were evaluated by reviewing all series of follow-up magnetic resonance imaging (MRI) scans, which were performed at 6 weeks, 3 months, 6 months, and 1 year postoperatively and every 2 years thereafter with the patient's agreement. Postoperative periods for allograft tears were defined as the time between surgery and the follow-up MRI scan in which the meniscal tear was first confirmed. Allograft tears were compared between the medial and lateral MAT groups.Results:A total of 327 consecutive patients who underwent MAT (55 medial, 272 lateral) with a minimum 2-year follow-up were retrospectively reviewed. The incidences of allograft tears after medial and lateral MATs were 32.7% and 30.9%, respectively. The mean times for tears were 80.1 ± 81.1 months and 48.9 ± 46.3 months in the medial and lateral MAT groups, respectively ( P = .130). In both the medial and lateral MAT groups, allograft tears were observed mainly in the posterior horn, with complex tears being the most commonly identified tear type. In medial MATs, root tears were the second most common at 27.8%, with a significantly higher proportion than the lateral MATs ( P = .014). On the other hand, in lateral MATs, meniscocapsular separation and radial tears were the second most common at 15.5% each, albeit not significantly more common than in medial MATs ( P = .123 and P = .454, respectively). All root tears in medial MATs and meniscocapsular separations in lateral MATs were observed within 1 year postoperatively.Conclusion:Significant differences in allograft tear patterns were identified between the medial and lateral MAT groups. The proportion of root tears in medial MATs was higher than that in lateral MATs; conversely, the proportion of meniscocapsular separation was more common in lateral MATs. Such tear patterns, which may require surgical repair or graft resection, were observed only within 1 year of surgery. Therefore, close observation and regular follow-up in the earlier postoperative period are necessary after medial or lateral MATs.

中文翻译：

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内侧和外侧半月板同种异体移植中移植物撕裂形态的差异：使用磁共振成像进行客观评估


背景：很少有研究比较采用骨固定技术的同种异体半月板移植（MAT）中同种异体半月板撕裂的特点。目的：调查采用骨固定技术进行同种异体半月板移植（MAT）后同种异体半月板撕裂的发生率、部位和模式，并比较撕裂情况根据手术后经过的时间，内侧间室和外侧间室之间的模式。 研究设计：队列研究；证据级别，3。方法：回顾性分析1996年12月至2019年6月期间接受初次内侧或外侧MAT的连续患者的图表。通过回顾所有系列的后续磁共振成像 (MRI) 扫描来评估同种异体移植撕裂发生的位置、模式和术后时期，这些扫描在术后 6 周、3 个月、6 个月和 1 年以及每年进行一次。 2年后经患者同意。同种异体移植撕裂的术后时间定义为手术和首次确认半月板撕裂的后续 MRI 扫描之间的时间。比较内侧和外侧 MAT 组之间的同种异体移植撕裂。结果：回顾性分析了总共 327 例连续接受 MAT 的患者（内侧 55 例，外侧 272 例）并至少随访 2 年。内侧和外侧 MAT 后同种异体移植撕裂的发生率分别为 32.7% 和 30.9%。内侧 MAT 组和外侧 MAT 组的平均流泪时间分别为 80.1 ± 81.1 个月和 48.9 ± 46.3 个月 ( P = .130)。在内侧和外侧 MAT 组中，主要在后角观察到同种异体移植物撕裂，其中复杂撕裂是最常见的撕裂类型。在内侧 MAT 中，牙根撕裂是第二常见的，排在 27 岁。8%，比例显着高于横向 MAT ( P = .014)。另一方面，在外侧 MAT 中，半月板囊分离和径向撕裂是第二常见的，各为 15.5%，尽管并不比内侧 MAT 中更常见（分别为 P = .123 和 P = .454）。术后 1 年内观察到内侧 MAT 中的所有牙根撕裂和外侧 MAT 中的半月板囊分离。结论：内侧 MAT 组和外侧 MAT 组之间的同种异体移植撕裂模式存在显着差异。内侧 MAT 的牙根撕裂比例高于外侧 MAT；相反，半月板囊分离的比例在外侧 MAT 中更为常见。这种撕裂模式可能需要手术修复或移植物切除，仅在手术后一年内观察到。因此，内侧或外侧 MAT 术后早期的密切观察和定期随访是必要的。