Arthroscopically assisted meniscal allograft transplantation with and without combined anterior cruciate ligament reconstruction

Yoldas, Erol A.; Sekiya, Jon K.; Irrgang, James J.; Fu, Freddie H.; Harner, Christopher D.

doi:10.1007/s00167-003-0362-y

Cited by 101 publications

(81 citation statements)

References 64 publications

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“…17 The number of previous knee operations was only described in three of the studies identified. [18][19][20] Whilst many review articles proffer that surgical results are best in those patients with Outerbridge Grade 3 or less chondral damage (Table 1), very few studies actually describe pre-operative grades for their patient subsets. Only two papers identified radiographic criteria used for assessing suitability for the procedure.…”

Section: Reviewmentioning

confidence: 99%

Meniscal Allograft Transplantation: A Review of the Current Literature

Crook

Ardolino

Williams

et al. 2009

annals

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INTRODUCTION Patients who have previously undergone meniscectomy are known to potentially suffer subsequent knee problems including degenerative changes. Meniscal transplantation has been proposed as a possble solution to these problems. This article aims to review the current literature to consolidate the evidence surrounding the use of human meniscal allograft transplantation. MATERIALS AND METHODS Three databases (PubMed, Embase and Medline) were searched to find English language articles pertaining to meniscal allograft transplantation. Each article was critiqued by two authors using a structured appraisal tool, and stratified according to the level of evidence. RESULTS No Level I or II studies were identified. Many studies had small study groups with limited follow-up and patient selection and description of patient factors varied greatly. This made comparing data difficult. There were also very few papers concentrating on isolated meniscal transplantation. Four types of graft are used – fresh, fresh-frozen, cryopreserved and freeze-dried (lyophilised) graft. Cryopreserved and fresh-frozen allografts are deemed most suitable. Most authors advocate the use of non-irradiated grafts from screened donors to reduce transmission of infection. Best results occur when using bony anchors to fix the graft, although this requires accurate graft positioning. Patients have an improved outcome if they have less severe degenerative changes within the knee prior to transplantation. CONCLUSIONS No statistically significant studies looking at isolated meniscal transplantations have been found. The evidence suggests that meniscal allograft transplantation provides improvement of pain and function in the short and intermediate term. The effect on future joint degeneration is still unknown. The ideal patient group includes patients less than 40 years of age with knee pain, proven meniscal injury and a normally aligned, stable joint without severe degenerative changes.

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Section: Reviewmentioning

confidence: 99%

Meniscal Allograft Transplantation: A Review of the Current Literature

Crook

Ardolino

Williams

et al. 2009

annals

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“…Standard meniscal suture repair methods were employed to suture the margin of the meniscus to the capsule and attach the meniscal allograft (5,16). Vertical sutures are typically employed to attach the meniscus from the rear 1/3 to the front in all cases and this was performed in the present study.…”

Section: Methodsmentioning

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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“…GonzalezLucena et al 176 performed MAT with suture fixation without any bone block and found a high rate of complications (33%) and revision surgery. Yoldas et al 177 examined clinical and patient-reported outcomes following meniscal allograft transplantation with bony fixation performed with bone plugs for medial transplants and using a bone bridge for lateral transplants.…”

Section: Meniscus Repair and Replacementmentioning

confidence: 99%

Meniscus tear surgery and meniscus replacement

Vaquero

Forriol

2016

MLTJ

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SummaryObjective: the menisci are easily injured and difficult to repair. The aim of this study was to analyze the current state of meniscal surgery aimed at preserving morphology and conserving the biomechanics of the knee to prevent joint degeneration. Methodology: a search of the electronic medical literature database Medline was conducted, from http://www.ncbi.nlm.nih.gov/pubmed. The search was not limited by language. Candidate articles were identified by searching for those that included the keywords meniscus, surgery, suture, implant, allograft. The limits were included for clinical research and clinical trials. Basic research was not included. The studies selected were evaluated and classified in three different categories: basic science, reconstruction (suture and meniscectomy) and implants (scaffolds and allograft). Results: the consequences of meniscectomy performed at a young age can lead to a joint cartilage degeneration twenty years later. There are few surgical options for the repair of meniscal injuries in order both to preserve the meniscus and to ensure the long term survival of the knee joint, meniscectomy, repair, suturing the tear, or reconstruction, when a meniscal allograft or synthetic substitute is used to replace the meniscus, but the biomechanical properties of the native meniscus are not reproduced entirely by the scaffolds that exist today.Conclusion: therapies that successfully repair or replace the meniscus are therefore likely to prevent or delay osteoarthritis progression.

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Arthroscopically assisted meniscal allograft transplantation with and without combined anterior cruciate ligament reconstruction

Cited by 101 publications

References 64 publications

Meniscal Allograft Transplantation: A Review of the Current Literature

Meniscal Allograft Transplantation: A Review of the Current Literature

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

Meniscus tear surgery and meniscus replacement

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