Current Status of Allograft Meniscal Transplantation

Veltri, Daniel M.; Warren, Russell F.; Wickiewicz, Thomas L.; O’Brien, Stephen J.

doi:10.1097/00003086-199406000-00007

Cited by 78 publications

(44 citation statements)

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“…14,18,51,61,63,72,85,88,93,94,96,99 Differences in tissue processing, secondary sterilization, preservation, operative techniques, and rating schemes make comparisons between studies difficult. 17,75 Rath et al 73 followed 22 patients with cryopreserved meniscal allografts for 2 to 8 years postoperatively.…”

Section: Meniscus Transplantationmentioning

confidence: 99%

“…Transplantation of human menisci was first reported in the English literature in 1984 51 and, while results of clinical investigations are mixed, the procedure is hypothesized to restore some load-bearing meniscus function. 28,53,54,61,63,72,73,79,85,88,89,93,96,98,99 In young active patients who have undergone meniscectomy, few other options currently exist. The results of shortand mid-term clinical studies have justified the procedure in patients who have pain or in whom articular cartilage deterioration in the meniscectomized compartment exists.…”

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confidence: 99%

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Meniscal Repair and Transplantation: Indications, Techniques, Rehabilitation, and Clinical Outcome

Heckmann

Barber-Westin²,

Noyes³

2006

J Orthop Sports Phys Ther

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The purpose of this paper is to provide current knowledge regarding the indications, operative techniques, rehabilitation programs, and clinical outcomes of meniscus repair and transplantation procedures. Meniscus tears that occur in the periphery may be repaired using a variety of operative procedures with high success rates. Complex multiplanar tears that extend into the central one-third avascular zone can also be successfully repaired using a meticulous vertically divergent suture technique. The outcome of these repairs justifies preservation of meniscal tissue, especially in younger athletic individuals. Meniscal transplantation is a valid treatment option for patients who have undergone meniscectomy and have related tibiofemoral joint pain, or in whom articular cartilage deterioration in the meniscectomized compartment is present. Rehabilitation after these operations includes knee motion and quadriceps-strengthening exercises initiated the first day postoperatively. The initial goal is to prevent excessive weight bearing and joint compressive forces that could disrupt the healing meniscus repair or transplant. The protocol contains modifications according to the type of meniscal tear, if a concomitant procedure is done (such as a ligament reconstruction) or if noteworthy articular cartilage deterioration is present. Patients who have repairs of peripheral meniscus tears are generally progressed more rapidly than those who have repairs of tears extending in the central one-third region or those who undergo meniscal transplantation. The safety and effectiveness of the rehabilitation program has been demonstrated in several clinical studies. We recommend preservation of meniscal tissue, regardless of age, in active patients whenever possible.

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Section: Meniscus Transplantationmentioning

confidence: 99%

mentioning

confidence: 99%

Meniscal Repair and Transplantation: Indications, Techniques, Rehabilitation, and Clinical Outcome

Heckmann

Barber-Westin²,

Noyes³

2006

J Orthop Sports Phys Ther

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“…7,35,36 A meniscal allograft will help to reduce the concentrated forces in the involved compartment and help protect the newly formed repair tissue. 7,36 We tend to favor meniscal transplantation in younger patients and adolescents with complete absent menisci, and certainly if early tibial articular wear is present.…”

Section: Meniscal Deficiencymentioning

confidence: 99%

Treatment of Full-Thickness Chondral Defects in the Knee With Autologous Chondrocyte Implantation

Gillogly¹,

Myers²,

Reinold³

2006

J Orthop Sports Phys Ther

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Autologous chondrocyte implantation (ACI) has now been performed for over a decade in the United States. ACI has been demonstrated as a reproducible treatment option for large, full-thickness, symptomatic chondral injuries of the knee. As clinical experience has expanded and indications broadened to more complex cartilage defects, it has become evident that aggressive treatment of coexisting knee pathology is essential for optimal results. This includes management of malalignment, ligamentous, and/or meniscal deficiency, and subchondral bone loss to make the intra-articular environment as ideal as possible for successful cartilage restoration. Additionally, refinements in the rehabilitation necessary for biologic cartilage repair have been made, based on better understanding of the maturation process of the repair cartilage, allowing for earlier initiation of knee range of motion, strengthening exercises, and weight bearing. These changes have enhanced the recovery for the patient and decreased the risk of motion deficits. This article will discuss patient selection for ACI, review ACI surgical technique, including management of coexisting knee pathology, present postoperative ACI rehabilitation guidelines, and summarize clinical outcomes after ACI.

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“…Studies demonstrating the ability of meniscal tissue to heal if attached to a well-vascularized periphery led to the hypothesis that transplanted allu graphic meniscal tissue would have the potential to revascularize and function within the recipient's knee (20,87). Animal studies have shown that meniscal allografts can heal to the recipient's vascular periphery and are capable of slowing the degenerative process when compared with meniscectomized knees (9,18,38,56).…”

Section: Allograft Meniscal Transplantationmentioning

confidence: 99%

“…The graft chosen for transplantation must be from the same side and compartment as the recipient (72,75,87). The graft is sized based on the anterior-posterior length of the tibia1 plateau determined by magnetic resonance imaging or radiographs (28,87).…”

Section: Allograft Meniscal Transplantationmentioning

confidence: 99%

Rehabilitation Following Allograft Meniscal Transplantation: A Review of the Literature and Case Study

Fritz¹,

Irrgang²,

Harner³

1996

J Orthop Sports Phys Ther

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Current Status of Allograft Meniscal Transplantation

Cited by 78 publications

References 0 publications

Meniscal Repair and Transplantation: Indications, Techniques, Rehabilitation, and Clinical Outcome

Meniscal Repair and Transplantation: Indications, Techniques, Rehabilitation, and Clinical Outcome

Treatment of Full-Thickness Chondral Defects in the Knee With Autologous Chondrocyte Implantation

Rehabilitation Following Allograft Meniscal Transplantation: A Review of the Literature and Case Study

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