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Verfasst von:Pawelczyk, Johannes [VerfasserIn]   i
 Fanourgiakis, Ilias [VerfasserIn]   i
 Feil, Sven [VerfasserIn]   i
 Siebold, Rainer [VerfasserIn]   i
Titel:Significant improvements in clinical outcome measures and patient satisfaction after combined all-arthroscopic meniscal allograft transplantation and autologous chondrocyte implantation
Titelzusatz:a single-centre longitudinal study
Verf.angabe:Johannes Pawelczyk, Ilias Fanourgiakis, Sven Feil und Rainer Siebold
E-Jahr:2024
Jahr:January 2024
Umfang:11 S.
Fussnoten:Gesehen am 28.03.2024
Titel Quelle:Enthalten in: Knee surgery, sports traumatology, arthroscopy
Ort Quelle:Berlin : Springer, 1993
Jahr Quelle:2024
Band/Heft Quelle:32(2024), 1, Seite 78-88
ISSN Quelle:1433-7347
Abstract:Purpose: The optimal treatment approach for the complex pathology of meniscal insufficiency and coexisting full-thickness cartilage defects remains unclear. The purpose of this study was to evaluate the viability, safety, and efficacy of this combined surgical approach at medium-term follow-up. Methods: This is a single-centre longitudinal study with blinded outcome assessment. All consecutive patients treated with combined all-arthroscopic meniscal allograft transplantation (MAT) with bone bridge fixation and ACI using chondrospheres at our institution between 2001 and 2021 were eligible for inclusion. Twenty patients with an average follow-up of 72.6 ± 34.4 months were included in the statistical analysis. Clinical outcomes were assessed pre- and postoperatively using the IKDC Subjective Knee Form, Lysholm Score, Tegner Activity Scale, KOOS, and Visual Analog Scale (VAS) for patient satisfaction. Failure and reoperation rates were assessed, and cartilage regeneration tissue was evaluated on postoperative MRI. Results: IKDC scores significantly improved from 52.1 ± 16.9 to 68.5 ± 16.3 (p = 0.003). Lysholm scores improved from 61.5 ± 21.7 to 78.5 ± 12.9 (p = 0.004). Tegner scores improved from 3.5 (1-4) to 4.0 (2-6) (p = 0.014). KOOS scores improved significantly across all subcategories, except ‘symptoms’, where improvements did not reach statistical significance. VAS for overall patient satisfaction showed improvements but did not reach statistical significance. The combined procedure was successful in 17 patients (85%). Eight patients had to undergo reoperation (40%), comprising mostly small, arthroscopic procedures. Seven reoperations were directly attributable to meniscal allograft transplantation (46.7%). Postoperative Magnetic Resonance Observation of Cartilage Repair Tissue scores were 68.9 ± 16.8 (n = 14). Conclusion: Combined arthroscopic MAT and autologous chondrocyte implantation (ACI) is a viable, safe, and effective treatment approach for younger patients with meniscal insufficiency and coexisting full-thickness cartilage damage, where alternative treatment options are limited. The combined surgical procedure achieved significant improvements in clinical outcome measures and patient satisfaction with acceptable failure and high arthroscopic reoperation rates. MAT is the limiting part of this combined procedure, with most failures and reoperations being attributable to MAT, as opposed to ACI. Level of Evidence: Level III.
DOI:doi:10.1002/ksa.12023
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1002/ksa.12023
 Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ksa.12023
 DOI: https://doi.org/10.1002/ksa.12023
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:arthroscopy
 autologous chondrocyte implantation
 cartilage restoration
 knee surgery
 meniscal allograft transplantation
 osteoarthritis
K10plus-PPN:1884658652
Verknüpfungen:→ Zeitschrift

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