Indications and limits of meniscal allografts

Meniscal Allograft Transplantation: Where are we Standing?

“…Overall, clinical and functional outcomes are satisfactory, and MAT is currently considered a safe, reliable and justified procedure in selected patients [6,7,9,12,13]. During the first 5 years after MAT, physicians can expect a mean Lysholm score of 80 points (range 60-100), with still values between 60 and 80 points at a follow-up between 10 and 20 years [7].…”

“…Many studies found significant improvements after MAT in the International Knee Documentation Committee (IKDC) [11,14,15,17,18,20], with percentages between 70 to 90% of nearly normal or normal values [21][22][23]. MAT has provided most patients with pain relief, adequate return to sports, and excellent satisfaction [6][7][8][9]10,11,14,15,17,18,21,[24][25][26][27]. In general, quality of life has even improved after MAT [28], with physical and mental component summary values above those for the matched U.S. population [22,23].…”

“…Nonetheless, return to high-level competitive sports has been also reported after MAT [24][25][26]. Clinical outcomes like knee effusion, range of motion, stability, or dynamic muscular tests have also improved with MAT [9]. Verdonk et al reported a mean cumulative survival time of 11.6 years, with no differences between medial and lateral allografts [29].…”

“…Thus, concomitant focal high-grade chodral osteochondral defects in the affected compartment, unacceptable axial malalignment or knee instability have to be corrected before or during MAT. Therefore, concomitant procedures such as cartilage repair, anterior cruciate ligament reconstruction, or tibial/femoral osteotomy can be also performed in the same operation [7][8][9]. Although some studies have reported acceptable results with MAT in patients with advanced cartilage defects (grades III and IV of the Outerbridge grading system) in terms of graft survival, pain relief, and function improvement [10,11], it is advisable to perform the MAT before these changes occur [9].…”

“…Therefore, concomitant procedures such as cartilage repair, anterior cruciate ligament reconstruction, or tibial/femoral osteotomy can be also performed in the same operation [7][8][9]. Although some studies have reported acceptable results with MAT in patients with advanced cartilage defects (grades III and IV of the Outerbridge grading system) in terms of graft survival, pain relief, and function improvement [10,11], it is advisable to perform the MAT before these changes occur [9]. Osteophyte formation, femoral condyle flattening, or obesity might be considered relative contraindications to MAT [9,12].…”