Homologous meniscus transplantation

Milachowski, K. A.; Weismeier, K.; Wirth, Carl Joachim

doi:10.1007/bf00266715

Cited by 406 publications

(113 citation statements)

References 21 publications

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“…Other researchers have studied the effects of meniscal transplantation. Milachowski et al [32] were the first to report their results with meniscal allograft transplantation in 1989. They performed medial meniscal transplantation in 22 knees and demonstrated that meniscal transplantation was a viable option but raised concerns over the use of freeze dried grafts (lyophilized) and graft shrinkage.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous animal and human studies have shown that transplanted menisci do heal, especially at the peripheral rim [5,6,15,21,32,49,50,51]. Correct sizing of the meniscal allograft is critical for healing.…”

Section: Indications For Meniscal Transplantationmentioning

confidence: 99%

“…Our interest in this procedure is based on both our experience and that of others with allograft ligament reconstruction [16,17,19,22,34,41] and on studies of meniscal allograft transplantation in animals [4,7,21,56] and in humans [5,6,15,23,24,32,33,37,46,49,50,51].…”

Section: Introductionmentioning

confidence: 99%

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

Yoldas

Sekiya

Irrgang

et al. 2003

Knee Surg Sports Traumatol Arthrosc

101

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The menisci provide a vital role in load transmission across the knee joint as well as contribute to knee stability, particularly in the ACL-deficient knee. Loss of the meniscus, in part or in total, significantly alters joint function and predisposes the articular cartilage to degenerative changes, which has been well documented both clinically and radiographically. This study examined clinical and patient-reported outcomes following meniscal allograft transplantation with and without combined ACL reconstruction in a select group of 31 patients with complaints of pain and/or instability (34 meniscal allografts); 11 underwent isolated meniscal transplantation and 20 meniscal transplantation combined with ACL reconstruction. Bony fixation was performed with bone plugs for medial transplants and using a bone bridge for lateral transplants. All patients completed several knee-specific and general measures of health-related quality of life and underwent a comprehensive physical examination. Flexion weightbearing PA radiographs at latest follow-up were compared to those obtained preoperatively. Mean follow-up was 2.9 years (range 2-5.5 years). The Activities of Daily Living and Sports Activities Scale scores were 86+/-11 and 78+/-16, respectively, and the average Lysholm score was 84+/-14. There were no significant differences in these scores based upon which meniscus (medial or lateral) was transplanted, concurrent ACL reconstruction, or the degree of chondrosis at arthroscopy. SF-36 scores indicated that patients were functioning at a level similar to the age- and sex-matched population. Twenty-two patients stated they were greatly improved, 8 were somewhat improved, 1 was without change. All but one patient reported that knee function and level of activity were normal or nearly normal. The average loss of motion compared to the noninvolved side was 3 degrees for extension and 9 degrees for flexion. All but one patient had a negative or 1+ Lachman's test. The remaining patient had a 2+ Lachman's test. Assessment with the KT-1000 arthrometer revealed a side-to-side difference of 2 mm (range -2 mm to 7 mm). Average hop and vertical jump indices were both 85% of the contralateral extremity. No statistically significant joint space narrowing was observed by radiography over time. Meniscal allograft transplantation with and without combined ACL reconstruction in carefully selected patients with complaints of compartmental joint line pain and/or instability appears able to provide relief of symptoms and restore relatively high levels of function, particularly during activities of daily living.

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Section: Discussionmentioning

confidence: 99%

Section: Indications For Meniscal Transplantationmentioning

confidence: 99%

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

Yoldas

Sekiya

Irrgang

et al. 2003

Knee Surg Sports Traumatol Arthrosc

101

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“…Milachowski from Munich, Germany, performed the first meniscus allograft transplantation in 1984 using lyophilisation as preservation method 4. Despite the observed shrinkage of the grafts, this study provided proof of principle that meniscus transplantation results in a remarkable clinical benefit.…”

Section: Introductionmentioning

confidence: 86%

Meniscal transplantation: state of the art

et al. 2017

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Meniscal resection is the most common surgical procedure in orthopaedics. When a large meniscal loss becomes clinically relevant, meniscal allograft transplantation (MAT) is a feasible option. However, although this technique has evolved since the ‘80s, there are still several controversial issues related to MAT. Most importantly, its chondroprotective effect is still not completely proven. Its relatively high complication and reoperation rate is another reason for this procedure not yet being universally accepted. Despite its controversial chondroprotective effect, nevertheless, MAT has become a successful treatment for pain localised in a previously meniscectomised knee, in terms of pain relief and knee function. We conducted a careful review of the literature, highlighting the most relevant studies in various aspects of this procedure. Precise indications, how it behaves biomechanically, surgical techniques, return to sport and future perspectives are among the most relevant topics that have been included in this state-of-the-art review.

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“…An transplant alleviates pain and improves function as well as having a satisfactory survival rate [10,11]. Drawbacks of these allografts are limited availability, size mismatching, high costs, graft shrinkage after implantation and risk of transmission of disease [12,13]. Alternatively, there are several biodegradable implants based on synthetic and natural polymers available but these implants demonstrate other disadvantages such as lack of durability in loading conditions [14][15][16].…”

Section: Introductionmentioning

confidence: 99%