Abstract
Meniscus allograft transplantation (MAT) is a proven treatment option for patients
with symptomatic irreparable meniscus deficiency. When patients are adherent to prescribed
postoperative restriction and rehabilitation protocols, outcomes after MAT are considered
good to excellent. However, nonadherence to standard protocols is common and can be
associated with undesirable outcomes and patient dissatisfaction. Based on demonstrated
safety for early weight-bearing following MAT in conjunction with significant advances
in graft preservation and surgical techniques, our joint preservation center implemented
a shift in practice toward accelerated weight-bearing following MAT and designed this
study to test the hypothesis that accelerated rehabilitation would be associated with
superior adherence, patient-reported outcomes, and patient satisfaction, without diminishing
patient safety, when compared with standard rehabilitation. Patients were included
for analyses when they had undergone fresh or fresh-frozen MAT using a double bone
plug technique for treatment of medial or lateral meniscus deficiency and had at least
1-year treatment outcomes recorded. The results of this study revealed that patients
who were prescribed accelerated rehabilitation after MAT were significantly more adherent
than patients who were prescribed standard rehabilitation and reported statistically
significant and clinically meaningful improvements in knee pain and function for at
least 1-year following MAT, whereas those in the standard cohort did not. While not
statistically different, treatment failure rate was lower in the accelerated rehabilitation
cohort when compared with the standard rehabilitation cohort (11 vs. 29%). Importantly,
initial outcomes for revision MAT were associated with short-term success in all the
patients who opted for this option in the study population. These data suggest that
accelerated weight-bearing after MAT is safe, promotes patient adherence, and is associated
with statistically significant and clinically meaningful improvements in patient-reported
knee pain and function at early and mid-term follow-up.
Keywords
meniscus allograft transplantation - weight-bearing - patient-reported outcomes
