Abstract
Objectives
The purpose of this study was to evaluate the clinical and imaging results in a series of patients who underwent a meniscal allograft transplant (MAT).
Methods
A retrospective study was performed. The International Knee Documentation Committee (IKDC) score, Lysholm score, and physical examinations were reviewed to measure clinical outcomes after MAT. Osteoarthritic changes were assessed by Plain radiography according to Kellgren-Lawrence (KL) classification and meniscal extrusion by magnetic resonance imaging (MRI). Surgical technique and related procedures were analyzed. Complications were registered. The minimum follow-up was 2 years.
Results
Surgeries were performed in 41 patients, 36 fulfilled the inclusion criteria. Twenty-five were male and 11 women. The mean age was 35 years old (SD 8). The mean follow-up was 71 months (range 24 to 184). The mean time between meniscectomy and meniscal transplant was 12.8 years (SD 6,7). Twenty-three were lateral menisci.
The following related procedures were performed: Seven ACL reconstructions, 3 ACL revisions, 19 mosaicplasties and 3 osteotomies. The mean preoperative results of IKDC and Lysholm scores were 30.3 (SD 15.5) and 43.8 (SD 16.8) respectively and postoperative results were 78.8 (SD 21.1) and 61.1 (SD 15) respectively.
There were no significative radiographic changes at the end of the follow-up. Mean KL preoperative was 2 (IQR 1) and last follow up was 2 (IQR 1) p= 0.053. Preoperative KL grade 1: 33%, grade 2: 50% and grade 3: 17% and last follow up KL grade 1: 22%, grade 2 56% and grade 3 22%.
The average percentage of extruded meniscus was 53% in 22 patients evaluated with MR (range 19% to 100%). Five presented arthrofibrosis that required mobilization under anesthesia and partial meniscectomy of the MAT was required in 6 patients. Two transplants failed.
Conclusion
Although 53% of meniscal extrusion was observed in the MR, we found no correlation with clinical outcomes. MAT achieved good clinical results without osteoarthritic changes after a mean of 6-years follow-up, with 5% of failure. MAT appears to be a safe and effective treatment, which should be considered as a suitable option in the clinical practice.