Midterm and Long-term Results of Medial Versus Lateral Meniscal Allograft Transplantation: A Meta-analysis

Bin, Seong‐Il; Nha, Kyung-Wook; Cheong, Ji-Young; Shin, Yang Sik

doi:10.1177/0363546517709777

Cited by 65 publications

(54 citation statements)

References 22 publications

(31 reference statements)

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“…Our subgroup analysis showed that lateral MAT produced better outcomes compared with medial MAT in two out of the four PROMs, although failure rates were comparable; this is in agreement with Bin et al 15 who published a meta-analysis of long-term outcomes of medial vs. lateral MAT and with other authors of cohort studies. 35,45,49 It is unclear why medial MAT is associated with significantly worse reported outcomes and graft survivorship.…”

Section: Discussionsupporting

confidence: 92%

“…We also identified areas in which there is need for more and better quality evidence, specifically concerning the role of preoperative chondral damage, sport level, time from meniscectomy, and smoking status, whose impact on clinical outcome is still controversial. Several systematic reviews and meta-analyses have been published in the last decade about MAT; these, however, were mostly introductory in their nature, [7][8][9][10][11][12] focused primarily on outcomes in general, 2,3,13,14 or evaluated one single predictor in detail, such as laterality, 15 the impact of concomitant procedures, 16 or the type of graft fixation. 17 Other reviewers considered particular aspects, such as the chondroprotective role of MAT 5 or the feasibility of sports activity after recovery.…”

Section: Discussionmentioning

confidence: 99%

“…Knee biomechanics could offer a possible explanation; as the lateral meniscus is the main actor in axial load transmission, 67 lateral meniscectomy produces a more severe contact load on the tibial plateau and more rapidly leads to OA and pain if untreated. 15,44 For this reason, patients with lateral meniscal defect tend to undergo transplants earlier and they present at surgery with a better baseline functional status. 15 Concerning isolated vs. combined MAT, a minority of authors have noted in the past that patients with accompanying deficiencies and needing multiple concomitant procedures were at greater risk of a poor postoperative outcome.…”

Section: Discussionmentioning

confidence: 99%

“…15,44 For this reason, patients with lateral meniscal defect tend to undergo transplants earlier and they present at surgery with a better baseline functional status. 15 Concerning isolated vs. combined MAT, a minority of authors have noted in the past that patients with accompanying deficiencies and needing multiple concomitant procedures were at greater risk of a poor postoperative outcome. 32,40,47,48 Similarly, we noted a higher postoperative Lysholm's score for isolated MAT, although there were no differences in the three other scales between the two situations.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Meniscal Allograft Transplantation Outcome: A Systematic Review

et al. 2019

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This systematic review investigates factors associated with outcomes after meniscal allograft transplantation (MAT). The PubMed, Scopus, and Cochrane Central Register databases were used to search relevant articles in April 2018. Studies that evaluated at least one association between a factor and outcomes were extracted. Of 3,381 titles, 52 studies were finally analyzed. Data about predictors, patient-reported outcome scores (PROMs), and failure rates were extracted for quantitative and qualitative analysis. A total of 3,382 patients and 3,460 transplants were identified. Thirty different predictors were reported in the current MAT literature, 18 of which by at least two studies. Subgroup analysis showed that lateral MAT had higher postoperative values than medial MAT in Lysholm's (p = 0.0102) and International Knee Documentation Committee (IKDC; p = 0.0056) scores. Soft tissue fixation showed higher postoperative IKDC scores than bone fixation (p = 0.0008). Fresh frozen allografts had higher Lysholm's scores (p < 0.0001) and showed significantly lower failure rates (p < 0.0001) than cryopreserved allografts. Age (p < 0.015, β = 0.80), sex (p < 0.034, β = − 8.52), and body mass index (BMI; p < 0.014, β = −4.87) demonstrated an association with PROMs in the regression model. Qualitative analysis found moderate evidence that a higher number of previous procedures in the same knee are an independent predictor of transplant failure. Conflicting evidence was found with regard to chondral damage, time from meniscectomy, smoke, sport level, worker's compensation status, and preoperative Lysholm's score as predictors of outcomes. Our review suggests that the ideal candidate to undergo MAT may be a young male of normal weight with no previous knee surgeries, treated with a lateral isolated procedure. However, MAT is associated with good outcomes in the majority of patients with many of the PROMs requiring further study to determine their direct effects on long-term outcomes. This study is a systematic review and reflects level of evidence IV.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predictors of Meniscal Allograft Transplantation Outcome: A Systematic Review

et al. 2019

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“…5,14 However, these studies are heterogeneous in terms of indications and techniques because they included patients with either medial or lateral compartment pathology due to valgus or varus malalignment. Because it is known that medial and lateral MATs show significantly different outcomes, with lateral MATs outperforming medial MATs in terms of functional improvement and pain relief, 15 it is necessary to delineate the outcomes between these procedures.…”

Section: See Commentary On Page 261mentioning

confidence: 99%

Return to Sport and Outcomes After Concomitant Lateral Meniscal Allograft Transplant and Distal Femoral Varus Osteotomy

Puzzitiello

Liu

Garcia³

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Addressing meniscal deficiency part 1: An umbrella review of systematic reviews and meta‐analyses on meniscal allograft transplantation

Wu,

Kiwinda,

Therien

et al. 2024

J. exp. orthop.

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PurposeMeniscal injuries are common in the young and active population. There is increasing utilization of surgical interventions like meniscal allograft transplantation (MAT) to restore the protective function of menisci following injury leading to meniscal deficiency. Extensive research and publications exist on the management of meniscal injury and the sequalae of meniscal deficiency. However, a comprehensive synthesis of the existing evidence through an umbrella review is lacking. This study aims to fill this gap by providing a current examination of the literature on MAT.MethodsA comprehensive search was conducted in the MEDLINE, Embase and Scopus databases to identify relevant systematic reviews and meta‐analyses. Studies were screened based on predefined inclusion and exclusion criteria. The quality of the included studies was assessed using the AMSTAR‐2 tool.ResultsA total of 41 studies were included in the review, with most published within the last decade. The majority of studies (56.1%) received a ‘Critically Low’ confidence rating, 26.8% were rated as ‘Low’, and only 14.6% were rated as ‘High’ confidence. From the included studies, 51.2% reported on PROMs, with the Lysholm score being the most common. Transplant failure and reoperation rate were reported in 34.1% and 19.5% of studies respectively. Studies on MAT reported favourable short‐term outcomes in terms of patient‐reported outcome measures (PROMs) but were limited by the lack of randomized control trials and consistent comparison groups.ConclusionsThis umbrella review highlights an increase in interest in MAT but underscores the need for higher‐quality reviews with standardized reporting and rigorous methodologies. Future research should focus on long‐term outcomes, optimal surgical techniques, patient selection criteria and risk factors for transplant failure. There is also a need for more studies focusing on MAT in pediatric populations. Overall, this review provides a comprehensive assessment of the current state of research in MAT and identifies areas for improvement in future studies.Level of EvidenceLevel IV.

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Midterm and Long-term Results of Medial Versus Lateral Meniscal Allograft Transplantation: A Meta-analysis

Cited by 65 publications

References 22 publications

Predictors of Meniscal Allograft Transplantation Outcome: A Systematic Review

Predictors of Meniscal Allograft Transplantation Outcome: A Systematic Review

Return to Sport and Outcomes After Concomitant Lateral Meniscal Allograft Transplant and Distal Femoral Varus Osteotomy

Addressing meniscal deficiency part 1: An umbrella review of systematic reviews and meta‐analyses on meniscal allograft transplantation

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