Meniscal Transplantation in Symptomatic Patients Less Than Fifty Years Old

Noyes, Frank R.; Barber-Westin, Sue D.; Rankin, Marc

doi:10.2106/00004623-200407000-00006

Cited by 181 publications

(82 citation statements)

References 44 publications

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“…Some studies [1, 2] have demonstrated that alignment correction was associated with regeneration of articular cartilage apparently normal, so in the last 10 years HTO has become very popular in association with new cartilage techniques and meniscal graft [3]. In the past years, knee malalignment associated with chronic instability and varus thrust has been considered a contraindication for HTO because of the poor results reported in literature [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner

Savarese

Bisicchia

Romeo

et al. 2010

J Orthopaed Traumatol

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High tibial osteotomy (HTO) is a surgical procedure used to change the mechanical weight-bearing axis and alter the loads carried through the knee. Conventional indications for HTO are medial compartment osteoarthritis and varus malalignment of the knee causing pain and dysfunction. Traditionally, knee instability associated with varus thrust has been considered a contraindication. However, today the indications include patients with chronic ligament deficiencies and malalignment, because an HTO procedure can change not only the coronal but also the sagittal plane of the knee. The sagittal plane has generally been ignored in HTO literature, but its modification has a significant impact on biomechanics and joint stability. Indeed, decreased posterior tibial slope causes posterior tibia translation and helps the anterior cruciate ligament (ACL)-deficient knee. Vice versa, increased tibial slope causes anterior tibia translation and helps the posterior cruciate ligament (PCL)-deficient knee. A review of literature shows that soft tissue procedures alone are often unsatisfactory for chronic posterior instability if alignment is not corrected. Since limb alignment is the most important factor to consider in lower limb reconstructive surgery, diagnosis and treatment of limb malalignment should not be ignored in management of chronic ligamentous instabilities. This paper reviews the effects of chronic posterior instability and tibial slope alteration on knee and soft tissues, in addition to planning and surgical technique for chronic posterior and posterolateral instability with HTO.

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Section: Introductionmentioning

confidence: 99%

Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner

Savarese

Bisicchia

Romeo

et al. 2010

J Orthopaed Traumatol

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“…Its indication for the treatment of highly active asymptomatic meniscectomized patients such as athletes is less suitable. However, Noyes et al34) reported 76% of patients in their study returned to light low-impact sports (such as bicycling and swimming) without problems. Recently, Noyes et al34) also reported 63% survival of meniscal transplants in the same patient population.…”

Section: Discussionmentioning

confidence: 87%

“…However, Noyes et al34) reported 76% of patients in their study returned to light low-impact sports (such as bicycling and swimming) without problems. Recently, Noyes et al34) also reported 63% survival of meniscal transplants in the same patient population. The latter study reveals that a decreased survival rate of 40% was observed at 15 years and the patients should be aware that a possible additional surgery can be needed at the end of this medium term.…”

Section: Discussionmentioning

confidence: 87%

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Meniscal Transplants and Scaffolds: A Systematic Review of the Literature

Dangelmajer

Familiari

et al. 2017

Knee Surg Relat Res

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The reported incidence of meniscal tears is approximately 61 per 100,000. In instances where preservation of the native meniscus is no longer a feasible option, meniscal allograft transplantation (MAT) and implants or scaffolds may be considered. The goal of this review was to compare the success and failure rates of two techniques, MAT and meniscal scaffolds, and make an inference which treatment is more preferable at the present time and future. Studies that met inclusion criteria were assessed for technique used, type of transplant used, number of procedures included in the study, mean age of patients, mean follow-up time, number of failures, failure rate, and reported reoperation rate. Fifteen studies for the MAT group and 7 studies for the meniscal scaffold group were identified. In this selection of studies, the average failure rate in the MAT group was 18.7% and average reoperation rate was 31.3%. The average failure rate in the meniscal scaffold group was 5.6%, and average reoperation rate was 6.9%. It appears that although MAT is associated with high reoperation and failure rates, the limited number of studies on both MAT and scaffolds and mainly short-term results of scaffold studies make it difficult to make an objective comparison.

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“…The most common candidates for the procedure are those who are ≥20 and <50 years of age with previous meniscectomy, have no severe degenerative changes and joint instability, present with local pain or swelling in the meniscus-deficient compartment, and show normal lower limb alignment16-18). Meniscus transplantation has been known to produce unsatisfactory results in the knees with advanced arthrosis, and hence, the procedure has been recommended in patients with Outerbridge grade I-II cartilage damage12,19,20). On the other hand, some recent studies reported that the procedure resulted in clinical and functional improvement when performed on carefully selected patients with Outerbridge grade III-IV cartilage damage21-24) and in combination with other procedures for cartilage injury12,25,26).…”

Section: Meniscus Transplantationmentioning

confidence: 99%

The Tips and Pitfalls of Meniscus Allograft Transplantation

Lee

Kim

Nam

2012

Knee Surg Relat Res

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When faced with an irrepairable meniscus or a patient who has had a total or subtotal meniscectomy, meniscus allograft transplantation (MAT) is the preferred modality to restore biomechanical function of the meniscus. The indications for meniscus allograft transplantation are yet to be established. However, currently, MAT has previously been indicated for symptomatic patients who have mild or early osteoarthritis, are younger than 50 years of age, and present with an Outerbridge grade II or lower. The short- to intermediate-term results confirmed noteworthy clinical improvements and consistent objective findings. On the other hand, the successful outcome would be reduced by various complications. Therefore, long-term observation required to evaluate the longevity of these results. The purpose of this article is to review the current research of concerns on the results of MAT, and to describe the technical tips and pitfalls so as to successful clinical results.

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Meniscal Transplantation in Symptomatic Patients Less Than Fifty Years Old

Cited by 181 publications

References 44 publications

Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner

Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner

Meniscal Transplants and Scaffolds: A Systematic Review of the Literature

The Tips and Pitfalls of Meniscus Allograft Transplantation

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