Is Sport Activity Possible After Arthroscopic Meniscal Allograft Transplantation?

Zaffagnini, Stefano; Grassi, Alberto; Muccioli, Giulio Maria Marcheggiani; Benzi, Andrea; Sarsina, Tommaso Roberti di; Signorelli, Cecilia; Raggi, Federico; Marcacci, Maurilio

doi:10.1177/0363546515621763

Cited by 55 publications

(59 citation statements)

References 18 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All protocols involve full load bearing 8 weeks after meniscal replacement. Nevertheless, these results are compatible with already published recommendations after meniscus replacement in which restriction of weight bearing have also been described up to 8 weeks after surgery [10,17,[35][36][37][38]. Even a mean return to full weight bearing after 6 weeks was confirmed by the findings of Rosso et al, who reviewed 55 studies investigating meniscus allograft transplantation [34], and by Filardo et al, who reviewed meniscus replacement by scaffolds [17].…”

supporting

confidence: 89%

“…Limited ROM was recommended in all patients with a minimum of 6 weeks after surgery and free ROM starting 9 weeks after surgery. These variations in early rehabilitation concepts are also reflected in the current literature; in that, full ROM is recommended from the 6 th postsurgical week onwards [10,17,[34][35][36]. With regard to the use of braces, there is a consensus in the evaluated rehabilitation protocols on the use of an orthosis for additional external joint stabilization for 8 postoperative weeks, even if the current literature is lacking such evidence.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Early Functional Rehabilitation after Meniscus Surgery: Are Currently Used Orthopedic Rehabilitation Standards Up to Date?

Koch

Memmel

Zeman

et al. 2020

Rehabilitation Research and Practice

View full text Add to dashboard Cite

Meniscus therapy is a challenging process. Besides the respective surgical procedure such as partial meniscectomy, meniscus repair, or meniscus replacement, early postoperative rehabilitation is important for meniscus regeneration and return to sport and work as well as long-term outcome. Various recommendations are available. However, the current literature lacks information concerning the actual early rehabilitation in daily routine recommended by orthopedic surgeons. Thus, the purpose of this study was to investigate currently used standard early rehabilitation protocols in the daily routine of orthopedic surgeons. This study investigated the recommendations and concepts for early rehabilitation after meniscus therapy given by German, Austrian, and Swiss orthopedic institutions. Standardized criteria such as weight bearing, range of motion, use of an orthosis, and rehabilitation training were analyzed according to the conducted surgical procedure: partial meniscectomy, meniscus repair, or meniscus replacement. The analysis of standard rehabilitation concepts for partial meniscectomy (n=15), meniscus repair (n=54), and meniscus replacement (n=7) showed significantly earlier functional rehabilitation in all criteria after partial meniscectomy in contrast to meniscus repair techniques (p<0.001). In addition, significant restrictions were found in full weight bearing, full range of motion, and the use of braces. In summary, a wide range of recommendations for weight bearing, ROM, brace therapy, and mobilization is available, particularly after meniscus repair and meniscus replacement. Most concepts are in accordance with those described in the current literature. Further research is necessary to enhance the scientific evidence on currently used early rehabilitation concepts after meniscus therapy.

show abstract

supporting

confidence: 89%

mentioning

confidence: 99%

Early Functional Rehabilitation after Meniscus Surgery: Are Currently Used Orthopedic Rehabilitation Standards Up to Date?

Koch

Memmel

Zeman

et al. 2020

Rehabilitation Research and Practice

View full text Add to dashboard Cite

show abstract

“…These findings make it difficult to draw a definite conclusion, thus a more homogeneous approach of reporting survival data is needed. A total of 167 out of 1665 patients converted to a prosthesis at a mean time of 10.5 years [3–8, 12, 13, 16–19, 23–27, 30, 33, 39, 53, 62, 65]. The complication rate of MAT is comparable to standard meniscal repair surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Based on a subpopulation of 1497 patients there is a complication rate of 15.6% (2.0%–51.4%) or 663 reported complications. A meniscal tear of the allograft is the most frequent complication, followed by debris removal in the joint space [5, 7, 9–16, 18, 19, 21–27, 29–31, 34–40, 42, 44, 45, 47, 50–58] (see Appendix C for a complete overview of all complications reported).…”

Section: Resultsmentioning

confidence: 99%

Meniscal allograft transplantation: a meta-analysis

Bruycker

Verdonk

2017

SICOT-J

View full text Add to dashboard Cite

Purpose: This meta-analysis evaluates the mid- to long-term survival outcome of MAT (meniscal allograft transplantation). Potential prognosticators, with particular focus on chondral status and age of the patient at the time of transplantation, were also analysed. Study design: Meta-analysis. Methods: An online database search was performed using following search string: “meniscal allograft transplantation” and “outcome”. A total of 65 articles were analysed for a total of 3157 performed MAT with a mean follow-up of 5.4 years. Subjective and clinical data was analysed. Results: The subjective and objective results of 2977 patients (3157 allografts) were analysed; 70% were male, 30% were female. Thirty-eight percent received an isolated MAT. All other patients underwent at least one concomitant procedure. Lysholm, Knee injury and Osteoarthritis Outcome (KOOS), International Knee Documentation Committee (IKDC) and Visual Analogue Scale (VAS) scores were analysed. All scores showed a good patient satisfaction at long-term follow-up. The mean overall survival rate was 80.9%. Complication rates were comparable to standard meniscal repair surgery. There was a degenerative evolution in osteoarthritis with at least one grade in 1760 radiographically analysed patients. Concomitant procedures seem to have no effect on the outcome. Age at transplantation is a negative prognosticator. The body mass index (BMI) of the patient shows a slightly negative correlation with the outcome of MAT. Conclusions: MAT is a viable solution for the younger patient with chronic pain in the meniscectomised knee joint. The complications are not severe and comparable to meniscal repair. The overall failure rate at final follow-up is acceptable and the allograft heals well in most cases, but MAT cannot be seen as a definitive solution for post-meniscectomy pain. The correct approach to the chronic painful total meniscectomised knee joint thus requires consideration of all pathologies including alignment, stability, meniscal abnormality and cartilage degeneration. It requires possibly combined but appropriate action in that order.

show abstract

“…Strenuous activity cannot be recommended, however, because repetitive high impacts can lead to producing unpredictable results in the allograft indemnity 33 74. Recently, some authors have shown that MAT could also be performed in those patients willing to resume highly demanding and competitive sport activities (such as soccer, basketball, rugby and volleyball) 81. They reported that 74% of patients were able to return to sport after a minimum rehabilitation period of 8 months.…”

Section: Allograft Extrusionmentioning

confidence: 99%

Meniscal transplantation: state of the art

et al. 2017

View full text Add to dashboard Cite

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.

show abstract

Is Sport Activity Possible After Arthroscopic Meniscal Allograft Transplantation?

Cited by 55 publications

References 18 publications

Early Functional Rehabilitation after Meniscus Surgery: Are Currently Used Orthopedic Rehabilitation Standards Up to Date?

Early Functional Rehabilitation after Meniscus Surgery: Are Currently Used Orthopedic Rehabilitation Standards Up to Date?

Meniscal allograft transplantation: a meta-analysis

Meniscal transplantation: state of the art

Contact Info

Product

Resources

About