Current status and imaging of allograft meniscal transplantation

Verstraete, Koenraad; Verdonk, René; Lootens, Tom; Verstraete, P; Rooy, Jacky de; Kunnen, Marc

doi:10.1016/s0720-048x(97)00028-4

Cited by 59 publications

(39 citation statements)

References 22 publications

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“…These cases could have been identified by magnetic resonance imaging, which has an established role in the diagnosis of meniscal lesions. However, the correlation between the findings of magnetic resonance imaging and the clinical outcome is still at issue 22,23,38 . A second limitation of our study was that the involved knee joints were evaluated clinically with the modified HSS scoring system 17 , which was originally designed for the evaluation of patients undergoing knee joint arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative magnetic resonance imaging was performed in a subset of patients for a separate analysis 22 . Although magnetic resonance imaging has an established role in the diagnosis of meniscal pathology, its value in the postoperative assessment of meniscal allografts is less clear.…”

Section: Clinical Kaplan-meier Survival Analysismentioning

confidence: 99%

“…Although magnetic resonance imaging has an established role in the diagnosis of meniscal pathology, its value in the postoperative assessment of meniscal allografts is less clear. The corre- lation between the findings of magnetic resonance imaging and the clinical outcome has been reported to be poor 22,23 . Hence, magnetic resonance imaging was not used to define clinical failure.…”

Section: Clinical Kaplan-meier Survival Analysismentioning

confidence: 99%

See 2 more Smart Citations

Transplantation of Viable Meniscal Allograft

Verdonk

Demurie

Almqvist

et al. 2005

The Journal of Bone & Joint Surgery

269

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Kaplan-meier Survival Analysismentioning

confidence: 99%

Section: Clinical Kaplan-meier Survival Analysismentioning

confidence: 99%

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Transplantation of Viable Meniscal Allograft

Verdonk

Demurie

Almqvist

et al. 2005

The Journal of Bone & Joint Surgery

269

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“…MRI was chosen because of its widely accepted use for visualization of meniscal pathology [16]. The major advantage of MRI is the high resolution of the images, allowing precise measurement of the extrusion (Fig.…”

Section: Discussionmentioning

confidence: 99%

Normal and transplanted lateral knee menisci: evaluation of extrusion using magnetic resonance imaging and ultrasound

Verdonk

Depaepe

Desmyter

et al. 2004

Knee Surg Sports Traumatol Arthrosc

124

119

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The aim of the study is to develop a clinically useful and reproducible method for evaluating lateral meniscal extrusion in normal and transplanted knees under different axial loading conditions. Magnetic resonance imaging (MRI) and ultrasound (US) were used to assess meniscal extrusion. Both types of imaging were performed at least 6 months postoperatively (mean 23.5 months). Coronal MR images (DESS-3D sequence) of the lateral compartments of 10 normal knees and 17 transplanted lateral knees were analyzed. Extrusion was defined as the distance measured from the femoral condyle or tibial plateau to the outer edge of the meniscus. Subjects were examined in the supine position. Ultrasound print-outs of the lateral compartment of both knees of ten patients (transplanted side and contralateral normal side) were analyzed. Extrusion cross-sectional area (CSA) and distance were measured just anterior to the lateral collateral ligament: the former was defined as the CSA of the meniscus outside the knee, the latter as the greatest distance from a line connecting the femur and tibia to the outer edge of the lateral meniscus. Patients were examined in the supine position, bipodal stance and unipodal stance. The viable meniscal allograft was securely sutured to a bleeding functional meniscal rim. No bone blocks were used to fix the allograft; instead, the anterior and posterior horn were firmly sutured to their enthesis. The MRI results (tibial) show the transplanted lateral meniscus to be significantly (p<0.005) more extruded in comparison to the normal lateral meniscus. The anterior horn (mean 5.8 mm, SD=2.8) of the transplanted lateral meniscus tends to be more extruded than the posterior horn (mean 2.7 mm, SD=1.48). The posterior horn of the normal lateral meniscus does not (mean 0 mm) extrude, while the mean extrusion of the anterior horn is 0.8 mm (SD=0.92). In the US results, the transplanted lateral meniscus is significantly (p<0.005) more extruded than the normal lateral meniscus in all patient positions. Both cross-sectional surface and distance are equally good parameters to determine meniscal extrusion. There is no statistical difference between patient positions. The transplanted lateral meniscus extrudes, in the supine position, bipodal and unipodal stance 6.43 (SD=1.84), 6.01 (SD=1.93) and 6.99 mm (SD=2.7) respectively. The extrusion surface of the lateral transplanted meniscus is 50.50 mm2 (SD=15.32), 47.24 mm2 (SD=14.35) and 58.61 mm2 (SD=29.65) in the supine position, bipodal stance and unipodal stance respectively. The normal lateral meniscus extrudes in the supine position, bipodal and unipodal stance 3.77 (SD=1.76), 3.94 (SD=1.66) and 3.79 mm (SD=1.79) respectively. The extrusion surface of the normal lateral meniscus is 22.42 mm2 (SD=12.54), 23.24 mm2 (SD=12.74) and 24.79 mm2 (SD=10.18) in the supine position, bipodal stance and unipodal stance respectively. The presented data shows that the transplanted lateral meniscus, without bone block fixation but with firm fixation of the horns to the original en...

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“…One of the important local mechanical factors is the integrity and function of the meniscus. The meniscus has many functions in the knee, including load bearing, shock absorption, stability enhancement, and lubrication (1,2). Knee OA after meniscectomy is traditionally considered a result of the joint injury that leads to the meniscectomy in the first instance, and the increased contact stress in the cartilage due to the loss of meniscal tissue (3)(4)(5)(6)(7)(8).…”

mentioning

confidence: 99%

The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis

Hunter¹,

Zhang²,

Niu³

et al. 2006

Arthritis & Rheumatism

448

406

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Objective. To explore the role of meniscal tears and meniscal malposition as risk factors for subsequent cartilage loss in subjects with symptomatic osteoarthritis (OA).Methods. Study subjects were patients with symptomatic knee OA from the Boston Osteoarthritis of the Knee Study. Baseline assessments included knee magnetic resonance imaging (MRI) with followup MRI at 15 and 30 months. Cartilage and meniscal damage were scored on MRI in the medial and lateral tibiofemoral joints using the semiquantitative whole-organ magnetic resonance imaging score. Tibiofemoral cartilage was scored on MR images of all 5 plates of each tibiofemoral joint, and the meniscal position was measured using eFilm Workstation software. A proportional odds logistic regression model with generalized estimating equations was used to assess the effect of each predictor (meniscal position factor and meniscal damage as dichotomous predictors in each model) on cartilage loss in each of the 5 plates within a compartment. Models were adjusted for age, body mass index (BMI), tibial width, and sex.Results. We assessed 257 subjects whose mean ؎ SD age was 66.6 ؎ 9.2 years and BMI was 31.5 ؎ 5.7 kg/m 2 ; 42% of subjects were female, and 77% of knees had a Kellgren/Lawrence radiographic severity grade >2. In the medial tibiofemoral joint, each measure of meniscal malposition was associated with an increased risk of cartilage loss. There was also a strong association between meniscal damage and cartilage loss. Since meniscal coverage and meniscal height diminished with subluxation, less coverage and reduced height also increased the risk of cartilage loss.Conclusion. This study highlights the importance of an intact and functioning meniscus in patients with symptomatic knee OA, since the findings demonstrate that loss of this function has important consequences for cartilage loss.Cartilage loss in knee osteoarthritis (OA) is a multifactorial process that is influenced by systemic risk factors such as age, sex, and obesity and by local mechanical factors such as alignment and injury. One of the important local mechanical factors is the integrity and function of the meniscus. The meniscus has many functions in the knee, including load bearing, shock absorption, stability enhancement, and lubrication (1,2). Knee OA after meniscectomy is traditionally considered a result of the joint injury that leads to the meniscectomy in the first instance, and the increased contact stress in the cartilage due to the loss of meniscal tissue (3-8). Meniscectomy is often accompanied by the onset of OA because of the high focal stresses imposed on articular cartilage and subchondral bone subsequent to excision of the meniscus. Studies of meniscectomy affirm the importance of loss of meniscal function as a risk factor for subsequent knee OA (9).Although meniscectomy appears to be an important risk factor for OA, we know little about the effect of meniscal tears and meniscal extrusion or subluxation on cartilage loss in knees with preexisting OA. Results from a cross-sectio...

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Current status and imaging of allograft meniscal transplantation

Cited by 59 publications

References 22 publications

Transplantation of Viable Meniscal Allograft

Transplantation of Viable Meniscal Allograft

Normal and transplanted lateral knee menisci: evaluation of extrusion using magnetic resonance imaging and ultrasound

The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis

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