Meniscal allograft transplantation. Part 2: systematic review of transplant timing, outcomes, return to competition, associated procedures, and prevention of osteoarthritis

Samitier, Gonzalo; Alentorn-Geli, Eduard; Taylor, Dean C.; Rill, Brian K.; Lock, Terrence R.; Moutzouros, Vasilius; Kolowich, Patricia A.

doi:10.1007/s00167-014-3344-3

Cited by 82 publications

(74 citation statements)

References 56 publications

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“…For meniscus injury, the meniscus should be preserved as much as possible in order to delay progression of degeneration of articular cartilage . After meniscectomy or meniscal degeneration, transplantations of the meniscal graft or artificial meniscus have been attempted; however, the outcome of the transplantations is still controversial . A new treatment to regenerate the meniscus is needed.…”

mentioning

confidence: 99%

Transplantation of autologous synovial mesenchymal stem cells promotes meniscus regeneration in aged primates

et al. 2017

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Transplantation of aggregates of synovial mesenchymal stem cells (MSCs) enhanced meniscus regeneration in rats. Anatomy and biological properties of the meniscus depend on animal species. To apply this technique clinically, it is valuable to investigate the use of animals genetically close to humans. We investigated whether transplantation of aggregates of autologous synovial MSCs promoted meniscal regeneration in aged primates. Chynomolgus primates between 12 and 13 years old were used. After the anterior halves of the medial menisci in both knees were removed, an average of 14 aggregates consisting of 250,000 synovial MSCs were transplanted onto the meniscus defect. No aggregates were transplanted to the opposite knee for the control. Meniscus and articular cartilage were analyzed macroscopically, histologically, and by MRI T1rho mapping at 8 (n = 3) and 16 weeks (n = 4). The medial meniscus was larger and the modified Pauli's histological score for the regenerated meniscus was better in the MSC group than in the control group in each primate at 8 and 16 weeks. Mankin's score for the medial femoral condyle cartilage was better in the MSC group than in the control group in all primates at 16 weeks. T1rho value for both the regenerated meniscus and adjacent articular cartilage in the MSC group was closer to the normal meniscus than in the control group in all primates at 16 weeks. Transplantation of aggregates of autologous synovial MSCs promoted meniscus regeneration and delayed progression of degeneration of articular cartilage in aged primates. This is the first report dealing with meniscus regeneration in primates. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1274-1282, 2017.

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confidence: 99%

Transplantation of autologous synovial mesenchymal stem cells promotes meniscus regeneration in aged primates

et al. 2017

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“…13 For MAT on the knee, current studies consistently reveal favorable clinical and functional results in young and active meniscectomized patients. 22 These improvements in symptoms, function, and quality of life were also shown at longer follow-up periods of 7–14 years. 22 Furthermore, according to Samitier et al, 22 although MAT does not necessarily prevent degeneration in previously healthy cartilage, it may prevent the progression of cartilage damaged at long-term follow-up.…”

Section: Discussionmentioning

confidence: 79%

“…22 These improvements in symptoms, function, and quality of life were also shown at longer follow-up periods of 7–14 years. 22 Furthermore, according to Samitier et al, 22 although MAT does not necessarily prevent degeneration in previously healthy cartilage, it may prevent the progression of cartilage damaged at long-term follow-up. Because of the successful use of MAT on the knee, this study aimed to demonstrate MAT as a valuable alternative to treating osteochondral defects of the radiocarpal, MCP, and PIP joints.…”

Section: Discussionmentioning

confidence: 79%

Successful Arthroplasty Using Cadaveric Meniscus for Osteochondral Defects in the Wrist and Hand Joints

Hoang

Chen

Gould

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:Osteochondral defects of the radiocarpal, metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints often necessitate joint arthrodesis or mechanical arthroplasty, which has a limited lifespan. In severely arthritic wrist and finger joints, we propose a novel adjunct for joint salvage using cadaveric meniscus for joint resurfacing as an off-the-shelf alternative to address osteochondral defects and restore normal intraarticular contact stress.Methods:A total of 14 patients with osteochondral defects in 5 radiocapitate, 5 MCP, 3 PIP, and 1 carpometacarpal joints received cadaveric meniscus to facilitate arthroplasty. Patient demographic, perioperative pain, range of motion, and complications were examined.Results:Patients aged 17 to 73 years old (average, 54.6 years old) underwent joint reconstruction for scaphoid nonunion (n = 1), scaphoid-lunate advanced collapse (n = 4), or osteoarthritis of MCP/carpometacarpal (n = 6) or PIP (n = 3) joints. Successful arthroplasty with joint space preservation occurred in all joints. Patients had a significant reduction in average pain scale score (P < 0.01) and improved average range of active motion degrees of flexion (P < 0.01) and degrees of extension (P < 0.05). No complications resulted; only a revision tenolysis and capsulotomy were required for PIP and MCP arthroplasties. Postoperative films reveal preservation of arthroplasty joint space after an average 19.7-month follow-up (range, 8–54).Conclusions:We believe that meniscus is a viable joint salvage option or adjunct to preserve pain-free motion and avoid total joint arthrodesis. In this series of 14 patients, we demonstrate the successful use of cadaver meniscus in hand joint arthroplasty, such that it advantageously maintains a low metabolic demand, is biointegratable, and is surgically malleable.

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“…However, despite being performed for over three decades, controversy persists regarding several of the finer aspects of MAT, including the following: Indications for surgery and patient selection, including age, symptoms and timing of surgery; graft preservation technique; fixation technique (bony fixation vs. an all-suture technique); postsurgical rehabilitation procedures; appropriate outcome measures, including Lysholm score, International Knee Documentation Committee (IKDC) subjective knee form, Tegner activity level score, Fulkerson questionnaire, WOMAC index, and the Kellgren and Lawrence OA grade; the impact of concomitant surgical procedures; impact on OA; and what is considered a successful surgery. These controversies continue to be salient in this field considering the growing number of MAT procedures performed annually together with the lack of controlled clinical studies and long-term follow-up data (2,4,6).…”

Section: Resultsmentioning

confidence: 99%

“…Although still relatively rare compared with other types of orthopedic surgery, meniscal allograft transplant (MAT) is a powerful tool for orthopedic surgeons that is gaining popularity due to the known complications of meniscectomy (6).…”

Section: Introductionmentioning

confidence: 99%

Meniscal allograft transplantation using a novel all-arthroscopic technique with specifically designed instrumentation

et al. 2018

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Abstract. The present study describes a novel all-arthroscopic technique for medial and lateral meniscal allograft transplantation (MAT). Surgical instruments were specifically designed to assist in the all-arthroscopic approach for MAT. The bone plug attachment technique, either the arthroscopic-assisted or all-arthroscopic approach, attaches bone plugs to the anterior and posterior horns. In the present study, two sets of surgical implements were designed: One to produce bone plugs of predefined sizes in the anterior and posterior horns of the allograft meniscus (bone plug implements) and a second to create bone tunnels in the receptor tibial plateau to hold the bone plugs (bone tunnel implements). The present study demonstrated that an all-arthroscopic approach to MAT was feasible. Furthermore, the specifically designed surgical instruments allowed for consistent preparation of grafts and recipient tissues, contributing to a standardized approach to MAT. The present findings indicate that an all-arthroscopic approach to MAT may be achievable. They also provide the incentive for future clinical studies to directly compare the outcomes and to initiate the standardization of the procedure to optimize MAT and maximize patient outcomes and quality of life.

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Meniscal allograft transplantation. Part 2: systematic review of transplant timing, outcomes, return to competition, associated procedures, and prevention of osteoarthritis

Abstract: Systematic review of level II-IV studies, Level IV.

Cited by 82 publications

References 56 publications

Transplantation of autologous synovial mesenchymal stem cells promotes meniscus regeneration in aged primates

Transplantation of autologous synovial mesenchymal stem cells promotes meniscus regeneration in aged primates

Successful Arthroplasty Using Cadaveric Meniscus for Osteochondral Defects in the Wrist and Hand Joints

Meniscal allograft transplantation using a novel all-arthroscopic technique with specifically designed instrumentation

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