Survivorship of Meniscal Allograft Transplantation in an Athletic Patient Population

Waterman, Brian R.; Rensing, Nicholas; Cameron, Kenneth L.; Owens, Brett D.; Pallis, Mark

doi:10.1177/0363546515626184

Cited by 54 publications

(83 citation statements)

References 30 publications

(34 reference statements)

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“…These outliers were authors who used multiple endpoints as criteria for failure such as reoperation, extrusion, meniscal tears, pain and alternate findings after imaging. It is also important to point out that studies with a follow-up time of more than seven years report greater failure rates [6, 8, 13, 37, 40, 51, 65, 66]. Most authors define failure as a clinical failure, being it a meniscectomy, a graft repair or an arthroplasty with or without a prosthesis.…”

Section: Resultsmentioning

confidence: 99%

“…These findings make it difficult to draw a definite conclusion, thus a more homogeneous approach of reporting survival data is needed. A total of 167 out of 1665 patients converted to a prosthesis at a mean time of 10.5 years [3–8, 12, 13, 16–19, 23–27, 30, 33, 39, 53, 62, 65]. The complication rate of MAT is comparable to standard meniscal repair surgery.…”

Section: Resultsmentioning

confidence: 99%

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Meniscal allograft transplantation: a meta-analysis

Bruycker

Verdonk

2017

SICOT-J

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Purpose: This meta-analysis evaluates the mid- to long-term survival outcome of MAT (meniscal allograft transplantation). Potential prognosticators, with particular focus on chondral status and age of the patient at the time of transplantation, were also analysed. Study design: Meta-analysis. Methods: An online database search was performed using following search string: “meniscal allograft transplantation” and “outcome”. A total of 65 articles were analysed for a total of 3157 performed MAT with a mean follow-up of 5.4 years. Subjective and clinical data was analysed. Results: The subjective and objective results of 2977 patients (3157 allografts) were analysed; 70% were male, 30% were female. Thirty-eight percent received an isolated MAT. All other patients underwent at least one concomitant procedure. Lysholm, Knee injury and Osteoarthritis Outcome (KOOS), International Knee Documentation Committee (IKDC) and Visual Analogue Scale (VAS) scores were analysed. All scores showed a good patient satisfaction at long-term follow-up. The mean overall survival rate was 80.9%. Complication rates were comparable to standard meniscal repair surgery. There was a degenerative evolution in osteoarthritis with at least one grade in 1760 radiographically analysed patients. Concomitant procedures seem to have no effect on the outcome. Age at transplantation is a negative prognosticator. The body mass index (BMI) of the patient shows a slightly negative correlation with the outcome of MAT. Conclusions: MAT is a viable solution for the younger patient with chronic pain in the meniscectomised knee joint. The complications are not severe and comparable to meniscal repair. The overall failure rate at final follow-up is acceptable and the allograft heals well in most cases, but MAT cannot be seen as a definitive solution for post-meniscectomy pain. The correct approach to the chronic painful total meniscectomised knee joint thus requires consideration of all pathologies including alignment, stability, meniscal abnormality and cartilage degeneration. It requires possibly combined but appropriate action in that order.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Meniscal allograft transplantation: a meta-analysis

Bruycker

Verdonk

2017

SICOT-J

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“…Although numerous studies have shown success with arthroscopic MAT alone, [3][4][5][6] few studiesdwith small patient cohort numbersdhave reported the results of concomitant MAT and ACLR in the ACL-and meniscus-deficient patient. Overall, those cohort studies that have been reported showed that patients have done well at short-and long-term follow-up with respect to outcome scores, knee pain, and satisfaction levels.…”

Section: Discussionmentioning

confidence: 99%

Concomitant Arthroscopic Meniscal Allograft Transplantation and Anterior Cruciate Ligament Reconstruction

Saltzman

Griffin

Wetters

et al. 2016

Arthroscopy Techniques

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In recent decades, arthroscopic meniscal allograft transplantation (MAT) has been refined as a robust option for the treatment of evolving unicompartmental tibiofemoral arthrosis in the setting of meniscal deficiency. It is imperative that the MAT be performed in a knee with anatomic stability and alignment to reduce aberrant biomechanical forces experienced by the allograft tissue to maintain its durability. Thus, in an anterior cruciate ligament (ACL)edeficient knee, ACL reconstruction (ACLR) must be performed to restore the stable knee environment for the MAT to succeed. Although these operations can be performed in staged fashion, a single-stage procedure with concomitant MAT and ACLR is an option. Its performance is technically demanding and requires careful consideration as to the intraoperative setup, incisions, graft options, surgical tools, and procedural order to properly secure the transplanted meniscal allograft and restore a functional, anatomic ACL. We present our preferred technique for concomitant arthroscopic MAT and ACLR, as well as some potential pitfalls and pearls to avoid pitfalls.

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“…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: 99%

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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Survivorship of Meniscal Allograft Transplantation in an Athletic Patient Population

Cited by 54 publications

References 30 publications

Meniscal allograft transplantation: a meta-analysis

Meniscal allograft transplantation: a meta-analysis

Concomitant Arthroscopic Meniscal Allograft Transplantation and Anterior Cruciate Ligament Reconstruction

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

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