Meniscal Allografts: Indications and Outcomes

Verdonk, René; Almqvist, Karl; Huysse, Wouter; Verdonk, Peter

doi:10.1097/jsa.0b013e318140002c

Cited by 42 publications

(23 citation statements)

References 36 publications

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“…[6][7][8] Their importance to the integrity of the knee is acknowledged by the shift towards attempted repair and more recently meniscal replacement rather than debridement or excision. 9,10 Several authors have reported that partial or total meniscectomy has detrimental effects and leads to radiological evidence of osteoarthritis (OA) of the knee in up to 50% of patients between five and 15 years postoperatively. [11][12][13] Unfortunately variable inclusion and exclusion criteria, inconsistent reporting on coexisting pathology within the knee and a lack in standardised means of data collection and analysis, are factors that make drawing firm conclusions difficult.…”

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confidence: 99%

Total meniscectomy in adolescents

Pengas

Assiotis

Nash

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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We continued a prospective longitudinal follow-up study of 53 remaining patients who underwent open total meniscectomy as adolescents and who at that time had no other intra-articular pathology of the knee. Their clinical, radiological and patient-reported outcomes are described at a mean follow-up of 40 years (33 to 50). The cohort of patients who had undergone radiological evaluation previously after 30 years were invited for clinical examination, radiological evaluation and review using two patient-reported outcome measures. A total of seven patients (13.2%) had already undergone total knee replacement at the time of follow-up. A significant difference was observed between the operated and non-operated knee in terms of range of movement and osteoarthritis of the tibiofemoral joint, indicating a greater than fourfold relative risk of osteoarthritis at 40 years post-operatively. All patients were symptomatic as defined by the Knee Injury and Osteoarthritis Outcome Score. This study represents the longest follow-up to date and it can be concluded that meniscectomy leads to symptomatic osteoarthritis of the knee later in life, with a resultant 132-fold increase in the rate of total knee replacement in comparison to their geographical and age-matched peers.

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confidence: 99%

Total meniscectomy in adolescents

Pengas

Assiotis

Nash

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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“…[1][2][3][4] Mid-and long-term studies have shown that medial and lateral allograft transplantation significantly reduces pain and improves the function of the knee. [5][6][7][8][9][10] Furthermore, successful outcome may be linked to the type of meniscus transplanted, with better results reported for lateral than for medial meniscal transplants.…”

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confidence: 99%

Comparison of medial and lateral meniscal transplantation with regard to extrusion of the allograft, and its correlation with clinical outcome

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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We compared extrusion of the allograft after medial and lateral meniscal allograft transplantation and examined the correlation between the extent of extrusion and the clinical outcome. A total of 73 lateral and 26 medial meniscus allografts were evaluated by MRI at a mean of 32 months (24 to 59) in 99 patients (67 men, 32 women) with a mean age of 35 years (21 to 52). The absolute values and the proportional widths of extruded menisci as a percentage were measured in coronal images that showed maximum extrusion. Functional assessments were performed using Lysholm scores. The mean extrusion was 4.7 mm (1.8 to 7.7) for lateral menisci and 2.9 mm (1.2 to 6.5) for medial menisci (p < 0.001), and the mean percentage extrusions were 52.0% (23.8% to 81.8%) and 31.2% (11.6% to 63.4%), respectively (p < 0.001). Mean Lysholm scores increased significantly from 49.0 (10 to 83) pre-operatively to 86.6 (33 to 99) at final follow-up for lateral menisci (p = 0.001) and from 50.9 (15 to 88) to 88.3 (32 to 100) for medial menisci (p < 0.001). The final mean Lysholm scores were similar in the two groups (p = 0.312). Furthermore, Lysholm scores were not found to be correlated with degree of extrusion (p = 0.242). Thus, transplanted lateral menisci extrude more significantly than transplanted medial menisci. However, the clinical outcome after meniscal transplantation was not found to be adversely affected by extrusion of the allograft.

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“…The cumulative survival rates for the medial and lateral meniscal allografts at 10 years were 74% and 70%, respectively [29]. Thus, the surgeon may expect an approximate survival of 70% of allografts at 10 years [30]. Several studies have reported the radiological outcomes of MAT [9].…”

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confidence: 99%

Meniscal Allograft Transplantation: Where are we Standing?

Monllau¹,

Alentorn-Geli²,

Pelfort³

et al. 2013

J Transplant Technol Res

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Meniscal allograft transplantation (MAT) is becoming a common procedure in Orthopedic departments worldwide. This procedure has demonstrated good and excellent results in terms of pain relief, improvement in clinical and functional outcomes, return to sports, and patient's satisfaction. However, MAT is not a universally accepted procedure due to its questionable chondroprotective effects and the relatively high rate of complications and/or reoperations. The present short review summarizes the principal indications, contraindications, outcomes, and complications. Also, it covers several controversial topics like graft preservation, graft sizing, graft fixation, results in MAT associated with concomitant procedures, and the role of MAT in the prevention of knee osteoarthritis.

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Meniscal Allografts: Indications and Outcomes

Cited by 42 publications

References 36 publications

Total meniscectomy in adolescents

Total meniscectomy in adolescents

Comparison of medial and lateral meniscal transplantation with regard to extrusion of the allograft, and its correlation with clinical outcome

Meniscal Allograft Transplantation: Where are we Standing?

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