Meniscal Allograft Transplantation

Rosso, Federica; Bisicchia, Salvatore; Bonasia, Davide Edoardo; Amendola, Annunziato

doi:10.1177/0363546514536021

Cited by 173 publications

(191 citation statements)

References 99 publications

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“…Worse outcomes have been reported without these corrections. 19 The acceptable degree of chondral loss is controversial, but the presence of full thickness chondral loss results in a poor local mechanical environment for the meniscal transplant to survive. Traditionally, meniscal transplantation was contraindicated in the presence of chondral loss (Outerbidge IV or ICRS 3b or 3c), but recently surgeons have accepted a higher failure rate in such patients and have combined transplantation with articular cartilage repair techniques.…”

Section: Indicationsmentioning

confidence: 99%

“…20 Pooled complication rates for isolated meniscal transplantation have ranged from 6 to 11%, although this is likely to significantly underestimate the true complication rate, as followup in some studies did not appear to be comprehensive. 19,25 One recently published large study (200 patients) found a 32% reoperation rate following meniscal allograft transplantation, with the majority of cases being just a simple debridement. 26 The average graft survival time has been reported to be between 10 and 16 years.…”

Section: Clinical Outcomesmentioning

confidence: 99%

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(v) Meniscal allograft transplantation and meniscal scaffolds; where are we up to now?

Smith

Parkinson

Spalding

2015

Orthopaedics and Trauma

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Section: Indicationsmentioning

confidence: 99%

Section: Clinical Outcomesmentioning

confidence: 99%

(v) Meniscal allograft transplantation and meniscal scaffolds; where are we up to now?

Smith

Parkinson

Spalding

2015

Orthopaedics and Trauma

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“…9 Complications often lead to additional surgical management. On the other hand, complication rates in MAT are low to acceptable 4,12,13 with reportedly low reoperation and revision rates even in an athletic population. 14 …”

Section: Introductionmentioning

confidence: 96%

Successful Arthroplasty Using Cadaveric Meniscus for Osteochondral Defects in the Wrist and Hand Joints

Hoang

Chen

Gould

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:Osteochondral defects of the radiocarpal, metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints often necessitate joint arthrodesis or mechanical arthroplasty, which has a limited lifespan. In severely arthritic wrist and finger joints, we propose a novel adjunct for joint salvage using cadaveric meniscus for joint resurfacing as an off-the-shelf alternative to address osteochondral defects and restore normal intraarticular contact stress.Methods:A total of 14 patients with osteochondral defects in 5 radiocapitate, 5 MCP, 3 PIP, and 1 carpometacarpal joints received cadaveric meniscus to facilitate arthroplasty. Patient demographic, perioperative pain, range of motion, and complications were examined.Results:Patients aged 17 to 73 years old (average, 54.6 years old) underwent joint reconstruction for scaphoid nonunion (n = 1), scaphoid-lunate advanced collapse (n = 4), or osteoarthritis of MCP/carpometacarpal (n = 6) or PIP (n = 3) joints. Successful arthroplasty with joint space preservation occurred in all joints. Patients had a significant reduction in average pain scale score (P < 0.01) and improved average range of active motion degrees of flexion (P < 0.01) and degrees of extension (P < 0.05). No complications resulted; only a revision tenolysis and capsulotomy were required for PIP and MCP arthroplasties. Postoperative films reveal preservation of arthroplasty joint space after an average 19.7-month follow-up (range, 8–54).Conclusions:We believe that meniscus is a viable joint salvage option or adjunct to preserve pain-free motion and avoid total joint arthrodesis. In this series of 14 patients, we demonstrate the successful use of cadaver meniscus in hand joint arthroplasty, such that it advantageously maintains a low metabolic demand, is biointegratable, and is surgically malleable.

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“…These patients may be treated by meniscal allograft transplantation (i.e. replacement of the native tissue with a donor meniscus) to relieve pain and restore knee function (Rosso et al, 2014). However, problems related to the availability and sizing of allografts, the risk of disease transmission and post-implantation remodeling (Lee et al, 2012;Wada et al, 1998), have driven the search for an alternative treatment.…”

Section: Introductionmentioning

confidence: 99%

The sensitivity of cartilage contact pressures in the knee joint to the size and shape of an anatomically shaped meniscal implant

Khoshgoftar¹,

Vrancken²,

Tienen³

et al. 2015

Journal of Biomechanics

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Since meniscal geometry affects the cartilage contact pressures, it is essential to carefully define the geometry of the synthetic meniscal implant that we developed. Recently, six independent modes of size- and shape-related geometry variation were identified through 3D statistical shape modeling (SSM) of the medial meniscus. However, this model did not provide information on the functional importance of these geometry characteristics. Therefore, in this study finite element simulations were performed to determine the influence of anatomically-based meniscal implant size and shape variations on knee cartilage contact pressures. Finite element simulations of the knee joint were performed for a total medial meniscectomy, an allograft, the average implant geometry, six implant sizes and ten shape variations. The geometries of the allograft and all implant variations were based on the meniscus SSM. Cartilage contact pressures and implant tensile strains were evaluated in full extension under 1200N of axial compression. The average implant induced cartilage peak pressures intermediate between the allograft and meniscectomy and also reduced the cartilage area subjected to pressures >5MPa compared to the meniscectomy. The smaller implant sizes resulted in lower cartilage peak pressures and compressive strains than the allograft, yet high implant tensile strains were observed. Shape modes 2, 3 and 6 affected the cartilage contact stresses but to a lesser extent than the size variations. Shape modes 4 and 5 did not result in changes of the cartilage stress levels. The present study indicates that cartilage contact mechanics are more sensitive to implant size than to implant shape. Down-sizing the implant resulted in more favorable contact mechanics, but caused excessive material strains. Further evaluations are necessary to balance cartilage contact pressures and material strains to ensure cartilage protection and longevity of the implant.

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Meniscal Allograft Transplantation

Cited by 173 publications

References 99 publications

(v) Meniscal allograft transplantation and meniscal scaffolds; where are we up to now?

(v) Meniscal allograft transplantation and meniscal scaffolds; where are we up to now?

Successful Arthroplasty Using Cadaveric Meniscus for Osteochondral Defects in the Wrist and Hand Joints

The sensitivity of cartilage contact pressures in the knee joint to the size and shape of an anatomically shaped meniscal implant

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