3D strain in native medial meniscus is comparable to medial meniscus allograft transplant

Kolaczek, Sandra; Hewison, Christopher; Caterine, Scott; Berardelli, Rebecca L.; Beveridge, Tyler S.; Herman, Benjamin; Hurtig, Mark B.; Gordon, Karen D.; Getgood, Alan

doi:10.1007/s00167-018-5075-3

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…11,39 However, sonography, which is a less invasive method, may provide promising information about meniscus extrusion during weight bearing. 40,41 In our study, it was observed that meniscal extrusion did not exhibit a statistically significant increase and was not higher than 3 mm during follow-up (2.27 vs. 2.98, 2.64 and 2.39). Therefore, it can be suggested that the combination of CBMA injection and surgical technique provides better meniscocapsular healing and provides lower rates of extrusion.…”

Section: Discussionmentioning

confidence: 44%

Medial Meniscus Scaffold Implantation in Combination with Concentrated Bone Marrow Aspirate Injection: Minimum 3-Year Follow-up

et al. 2020

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AbstractThe objective of this study is to show the short-term clinical and radiological outcomes of concentrated bone marrow aspirate (CBMA) injection administered in combination with medial meniscus scaffold implantation. Twenty-three patients who received intra-articular CBMA injection in combination with polyurethane-based medial meniscus scaffold implantation were evaluated within the scope of this study. The International Knee Documentation Committee (IKDC) questionnaire and the Knee injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate the results, and the visual analog scale was used to assess the pain scores. Magnetic resonance imaging (MRI) scans were obtained in the preoperative period and at postoperative months 1, 12, 24, and 36 to assess the scaffold position as well as chondral degeneration/damage in a comparative manner. MRI assessment was performed by using the modified Outerbridge scale for cartilage and the Genovese scoring system for the meniscal implant. Twenty-three patients who were included in the study were evaluated for a mean follow-up period of 38.3 months. Patients exhibited statistically significant improvement according to all scoring data from the preoperative period until the follow-up period. The mean postoperative extrusion at year 3 was 2.39 mm (distribution 2.30–2.56 mm). There was no significant difference in the distribution of the degree of chondral damage between the preoperative and 3-year follow-up periods. Four patients did not show any improvement nor had lower scores according to the assessment. Medial meniscus scaffold implantation combined with intra-articular CBMA injection resulted in a significant improvement in all functions and pain scores as well as a statistically significant clinical improvement in IKDC and KOOS values in the short-term follow-up. The Level of evidence for this study is IV.

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Section: Discussionmentioning

confidence: 44%

Medial Meniscus Scaffold Implantation in Combination with Concentrated Bone Marrow Aspirate Injection: Minimum 3-Year Follow-up

et al. 2020

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“…Accurate positioning of a meniscal allograft is thought to be an important factor for successful outcomes after MAT. 14 , 23 The nonanatomic graft position can cause disadvantages in knee biomechanics. In particular, when the graft position is >5 mm away from the native meniscus, it can affect the contact pressure and adversely affect the cartilage prevention ability of the graft.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…In the bone plug method, proper meniscal size and exact visualization of the native meniscal insertion is a key factor for the chondroprotective effect, but passing the graft through a tight medial joint with a cylindrical bone plug can be difficult. 9,14 These different surgical techniques may lead to different results, including meniscal extrusion, meniscal tear, progression of degenerative change, and clinical outcomes. 18 The purpose of this study was to assess the accuracy of anatomic restoration in the MMAT and LMAT procedures and compare the clinical and imaging outcomes, including postoperative follow-up magnetic resonance imaging (MRI).…”

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confidence: 99%

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Assessment of Anatomic Restoration and Clinical Outcomes Between Medial and Lateral Meniscal Allograft Transplantation

Jeong

Kim

Nam

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Proper anatomic restoration is an important consideration for meniscal allograft transplantation (MAT), even with the different anatomica characteristics between the medial meniscus and lateral meniscus. Purpose/Hypothesis: The purpose of this study was to assess the accuracy of anatomic restoration in medial and lateral MAT (MMAT and LMAT) procedures and to compare their outcomes. We hypothesized that (1) the anatomic differences between the medial and lateral menisci will mean a less accurate anatomic restoration for MMAT and (2) clinical outcomes after MMAT will be inferior compared with LMAT. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively evaluated 20 patients who underwent MMAT using the bone plug technique and 21 patients who underwent LMAT using the keyhole technique at a single institution from July 2014 to June 2019. Demographic data, previous surgeries, and concomitant procedures were recorded, as were lower limb alignment and osteoarthritis grade on radiographs. Using preoperative and follow-up magnetic resonance imaging, the meniscal position, rotation, extrusion, and intrameniscal signal intensity were evaluated. Clinical outcomes were evaluated using the International Knee Documentation Committee and Lysholm scores. Results: The mean follow-up was 41.15 ± 18.86 and 45.43 ± 21.32 months for the MMAT and LMAT patients, respectively. Concomitant procedures were performed in 90% of MMATs and 15% of LMATs. There was no significant difference between the native and postoperative root positions after LMAT; however, for MMAT, the position of the anterior root was located significantly posteriorly ( P = .002) and medially ( P = .007) compared with preoperatively. In addition, the allograft medial meniscus was restored in a more internally rotated position ( P = .029). MMATs also exhibited significantly increased meniscal extrusion compared with LMATs (posterior horn, P < .001; midbody, P = .027; anterior horn, P = .006). However, there was no significant difference between the 2 groups at final follow-up in intrameniscal signal intensity or clinical scores. Conclusion: LMAT showed higher accuracy than MMAT in restoring meniscal position and rotation, and there was less meniscal extrusion. However, clinical scores improved after both LMAT and MMAT compared with preoperative values, and midterm clinical outcomes were similar. The small anatomical errors seen in the MMAT technique were not clinically relevant at midterm follow-up.

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“…There are limited human data regarding the strain pattern and distribution after MAT; however, one study did use advanced 3-dimensional imaging to evaluate the strain placed on the meniscus, both for the native and transplanted meniscus. They found no significant difference in the total strain or the regional strain distribution between the native meniscus and allograft 33 . In addition, when nonirradiated allografts were assessed in rabbits 6 months after transplantation using indentation testing, there were no significant differences between the nonoperative contralateral meniscus and the transplanted one 34 .…”

Section: Biomechanics After Transplantmentioning

confidence: 93%

A Transplant or a Patch? A Review of the Biologic Integration of Meniscus Allograft Transplantation

Lichtig,

Bedi,

Koh

et al. 2023

JBJS Reviews

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» After transplantation revascularization does occur although data are only available for animal models.» The time zero biomechanics, that is, the biomechanical properties at the time of transplant, of a meniscus allograft transplantation appear to appropriately mimic the original so long as the graft is sized correctly within 10% of the original and bone plug fixation is used.» Allograft type, that is, fresh vs. frozen, does not appear to affect the integration of the allograft.

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3D strain in native medial meniscus is comparable to medial meniscus allograft transplant

Abstract: These results suggest that time zero MAT performs in a similar manner to the native meniscus. Optimizing MAT strain behavior may lead to potential improvements in its chondroprotective effect.

Cited by 7 publications

References 22 publications

Medial Meniscus Scaffold Implantation in Combination with Concentrated Bone Marrow Aspirate Injection: Minimum 3-Year Follow-up

Medial Meniscus Scaffold Implantation in Combination with Concentrated Bone Marrow Aspirate Injection: Minimum 3-Year Follow-up

Assessment of Anatomic Restoration and Clinical Outcomes Between Medial and Lateral Meniscal Allograft Transplantation

A Transplant or a Patch? A Review of the Biologic Integration of Meniscus Allograft Transplantation

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