Medial Meniscus Allograft Transplantation Using a Modified Bone Plug Technique: Clinical, Radiologic, and Arthroscopic Results

Ha, Jeong Ku; Sung, Jung Hwan; Shim, Jae Chan; Seo, Jeong Gook

doi:10.1016/j.arthro.2011.02.013

Cited by 44 publications

(30 citation statements)

References 20 publications

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“…But when compared to the contralateral knee, the difference is not significant. These results indicate that MAT provides a good function and integration in the index knee [3, 7, 29, 31, 33, 36, 37, 40, 43, 52, 53]. …”

Section: Resultsmentioning

confidence: 90%

“…An important finding is that most of the patients had only a slight progression of osteoarthritis with a mean of one grade [20]. This restrains the chondroprotective effect suggested by many authors in long-term follow-up [7, 9, 11–19, 21–26, 29–32, 34–36, 38, 41–48, 51–58]. …”

Section: Resultsmentioning

confidence: 99%

“…Shrinking also occurs. Usually 25% or sometimes up to 50% although this is difficult to measure [3, 7, 29, 31, 33, 36, 37, 40, 43, 52, 53]. …”

Section: Resultsmentioning

confidence: 99%

“…When evaluating the allograft with arthroscopy most authors refer to good integration of the allograft in situ. Some studies refer to shrinking of the allograft [9, 14, 29, 32, 36, 50, 56]. …”

Section: Discussionmentioning

confidence: 99%

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Meniscal allograft transplantation: a meta-analysis

Bruycker

Verdonk

2017

SICOT-J

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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.

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Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

“…Shrinking also occurs. Usually 25% or sometimes up to 50% although this is difficult to measure [3, 7, 29, 31, 33, 36, 37, 40, 43, 52, 53]. …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Meniscal allograft transplantation: a meta-analysis

Bruycker

Verdonk

2017

SICOT-J

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“…Ha et al38) performed second-look arthroscopy at a minimum of 2 years after medial MAT in 11 out of 22 cases, which revealed complete healing in more than 80% of the patients and cartilage degeneration in 4 cases (36.4%). Kim et al39) confirmed with MRI or second-look arthroscopy that the allografts were graded as satisfactory in 20 cases (69.0%), fair in 5 cases (17.2%) at a minimum of 2 years after 29 isolated lateral MAT.…”

Section: Evaluation Methods For Meniscal Transplantsmentioning

confidence: 99%

Review of Meniscal Allograft Transplantation Focusing on Long-term Results and Evaluation Methods

Lee

Kim

Sohn

et al. 2013

Knee Surg Relat Res

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With recognition of the biomechanical role of the meniscus, such as load distribution and joint stability in the knee joint, there has been a shift in the treatment of meniscal tears from open total meniscectomy to preservation of the meniscal functions as much as possible with symptomatic relief. Recently, technical development of meniscal surgery, with advanced arthroscopic equipment and instruments, enables biological reconstruction of load bearing functions in the meniscus deficient knee through allograft tissue transplantation as well as repair of torn menisci. Meniscal allograft transplantation (MAT) has been considered as one of the few viable treatment options for the young meniscectomized knees based on various animal experiments and clinical studies. Still, there is insufficient evidence for the long-term chondroprotective effect of human MAT. Some long-term follow-up studies showed that the technique resulted in graft degeneration, deformation, and tear, and structural changes in the remodeling process in early MAT cases, disrupting functional restoration of the original meniscus. Nevertheless, advanced outcomes are documented in some recent studies. The purpose of this article is to review the mid- and long-term follow-up results of MAT and to improve understanding of MAT with evaluation methods of meniscal transplants using magnetic resonance imaging or second-look arthroscopy.

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