Adequate size matching and anatomically correct positioning must be recognized as essential factors influencing the outcome of meniscal transplantation.
Hypothesis:
Nonanatomical insertion and incongruence of meniscal transplants has an influence on the development of degenerative changes.
Study Design:
Controlled laboratory study.
Methods:
Ten female sheep were used for this animal study. Both knees (N = 20) were divided into 3 groups, subjected to either meniscectomy (group I; n = 10), to a medial meniscal autograft transplantation with a nonanatomical insertion of the anterior and posterior horn (group II; n = 5), or a meniscal autograft transplantation from the opposite knee as an incongruent meniscal autograft (group III; n = 5). After 6 months, radiographic (Fairbank's criteria), macroscopic (Jackson score), and histological evaluation by light microscopy (Mankin score) and scanning electron microscopy of the articular cartilage was performed.
Results:
All applied evaluation methods demonstrated that nonanatomical insertion of meniscal transplants resulted in the highest amount of degenerative cartilage changes. The histological assessment even revealed a significantly enlarged cartilage damage for the non-anatomic-positioned meniscal transplants in relation to the meniscectomized knees. Furthermore, the incongruent meniscal transplants demonstrated a significantly better cartilage situation than nonanatomically inserted meniscal transplants.
Conclusion:
The histological evaluation demonstrated clearly that a nonanatomically inserted meniscal transplant leads to degenerative cartilage changes that are worse than that after meniscectomy.
Clinical Relevance:
Precise anatomic positioning is mandatory for the potential chondroprotective effect of meniscal transplants.
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