Obesity and Meniscal Transplant Failure: A Retrospective Cohort Study

Abstract

The purpose of this study was to analyze the effect of obesity and other clinical factors on the outcome of meniscal allograft transplantation (MAT) with transosseous fixation. A retrospective cohort study was performed on patients who underwent a MAT between 2002 and 2017. All the participants had a minimum follow-up period of 24 months. The variables assessed were age at the time of the transplant, side, sex, transplanted meniscus (lateral/medial), body mass index (BMI), smoking status, and previous surgeries. Lysholm, Tegner, and International Knee Documentation Committee (IKDC) test outcomes, and patient satisfaction were recorded. Image assessment was performed using plain standing X-rays and a follow-up magnetic resonance imaging scan. Thirty-five patients fulfilled the inclusion criteria. The mean follow-up time was of 75.7 standard deviation (SD) 43.4 months. Patients with a BMI ≥ 30 underwent medial meniscal transplants (88.9 vs. 42.3%, p = 0.022, respectively) more frequently. Obese patients had a significantly lower IKDC (48.6 SD 19.9 vs. 61.7 SD 13.1, p = 0.038, power: 57.5%) and Lysholm (60.3 SD 19.2 vs. 79.4 SD 14.3, p = 0.004, power: 88.7%) scores compared with nonobese patients. The satisfaction and Tegner scores were also lower in obese patients (55.6 vs. 80.7%, p = 0.136, and 2.8 SD 1.0 vs. 4.0 SD 1.9, p = 0.104, respectively); however, these differences were not statistically significant. Obese patients had higher rates of meniscal transplant failure compared with nonobese patients (adjusted hazard ratio: 11.8 [95% confidence interval: 1.5–91.4]). No differences were observed between obese and nonobese patients regarding age, sex, side, smoking status, and follow-up time. In this study, a BMI ≥ 30 kg/m2 resulted in higher MAT failure rates. Nonobese patients had better knee functional results compared with obese individuals.

Effect of ICRS Lesion Grade on Graft Survival After Medial Meniscal Allograft Transplantation: MRI-Based Objective Evaluation

“…Other patient factors such as BMI, age, and mechanical axis had no significant effect on the survival rate of the graft in this study. However, according to Jimenez-Garrido et al, 9 patients with obesity had a higher rate of graft failure. In our study, the BMI of the patients was 25.62 6 3.70, which indicated that the patients were in the overweight category but did not have obesity.…”

Meniscal allograft transplantation: a review of indications, techniques, and outcomes

“…The presence of osteophytes has been found to significantly increase allograft extrusion [16], and increased failure with higher KL scores has been found in patients undergoing combined MAT with ACLR [40]. Higher MAT failure rates have also been found in patients with a BMI > 30 kg/m 2 along with worse functional results [17].…”

Time to Achieving Clinically Significant Outcomes After Meniscal Allograft Transplantation

“…For example, Zaffagnini et al 23 did not find any significant effect of BMI on PROs, including KOOS, Lysholm, and visual analog scale (VAS), in a cohort of 117 patients at a mean follow-up of 4.0 ± 1.9 years. In contrast, a case-control study by Jimenez-Garrido et al 24 reported that patients with a BMI >30 kg/m 2 had significantly lower IKDC scores, on average about 12 points lower, than nonobese patients. In addition, the obese cohort had significantly higher failure rates, although this outcome measure was not assessed in the present study.…”