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J Knee Surg 2012; 25(02): 165-176
DOI: 10.1055/s-0032-1313738
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prospective Long-Term Evaluation of Meniscal Allograft Transplantation Procedure: A Minimum of 7-Year Follow-Up

Bryan M. Saltzman
1   Division of Sports Medicine, Department of Orthopedics, Rush University Medical Center, Chicago, Illinois
,
Sarvottam Bajaj
1   Division of Sports Medicine, Department of Orthopedics, Rush University Medical Center, Chicago, Illinois
,
Michael Salata
2   Department of Orthopedics, University Hospitals Case Medical Center, Cleveland, Ohio
,
Erika L. Daley
1   Division of Sports Medicine, Department of Orthopedics, Rush University Medical Center, Chicago, Illinois
,
Eric Strauss
3   Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
,
Nikhil Verma
4   Department of Orthopedics, Rush University Medical Center, Chicago, Illinois
,
Brian J. Cole
1   Division of Sports Medicine, Department of Orthopedics, Rush University Medical Center, Chicago, Illinois
› Author Affiliations
Further Information

Publication History

04 March 2011

27 November 2011

Publication Date:
15 May 2012 (online)

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Abstract

This study reports the long-term effectiveness of meniscal allograft transplantation performed by a single senior operating surgeon. In this study 22 meniscus transplantations in 22 patients were evaluated at a minimum of 7-year follow-up (mean 8.5 ± 1.3 years) using standardized scoring scales. Subgroup analysis was performed to stratify outcomes based on medial (59.1%) versus lateral (40.9%) meniscus transplantation, and transplantations performed in isolation (36.4%) versus those performed concomitantly (63.6%). Patients reported significant improvement in all scoring scales (p < 0.05). Average satisfaction was 8.8 out of 10. All the patients were completely or mostly satisfied with the results of their surgery. Overall subjective knee condition improved from 3.5 to 6.9 (p < 0.05). Patients undergoing medial compartment repair and combined transplantations reported greater improvement from baseline to follow-up than did their counterparts. An overall success rate of 88% was found for all patients at the final follow-up. Based on this data, meniscal allograft transplantation is a viable treatment option for meniscal-deficient patients in reducing pain, increasing range of motion, and improving patient function and satisfaction at a minimum of 7 years postsurgery.

Keywords

meniscus - meniscus transplant - meniscectomy - allograft - long-term efficacy
 

  • References

  • 1 Sekiya JK, Ellingson CI. Meniscal allograft transplantation. J Am Acad Orthop Surg 2006; 14 (3) 164-174
    CrossrefPubMedGoogle Scholar
  • 2 Baratz ME, Fu FH, Mengato R. Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report. Am J Sports Med 1986; 14 (4) 270-275
    Google Scholar
  • 3 Seedhom BB, Hargreaves DJ. Transmission of load in the knee joint with special reference to the role of the menisci, part II: experimental results, discussions, and conclusions. Eng Med 1979; 8: 220-228
    CrossrefPubMedGoogle Scholar
  • 4 Dandy DJ, Jackson RW. Meniscectomy and chondromalacia of the femoral condyle. J Bone Joint Surg Am 1975; 57 (8) 1116-1119
    PubMedGoogle Scholar
  • 5 Lubowitz JH, Verdonk PCM, Reid III JB, Verdonk R. Meniscus allograft transplantation: a current concepts review. Knee Surg Sports Traumatol Arthrosc 2007; 15 (5) 476-492
    CrossrefPubMedGoogle Scholar
  • 6 Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br 1961; 43–B: 752-757
    PubMedGoogle Scholar
  • 7 Allen PR, Denham RA, Swan AV. Late degenerative changes after meniscectomy. Factors affecting the knee after operation. J Bone Joint Surg Br 1984; 66 (5) 666-671
    Google Scholar
  • 8 Berthiaume MJ, Raynauld JP, Martel-Pelletier J , et al. Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis 2005; 64 (4) 556-563
    CrossrefPubMedGoogle Scholar
  • 9 Cox JS, Nye CE, Schaefer WW, Woodstein IJ. The degenerative effects of partial and total resection of the medial meniscus in dogs' knees. Clin Orthop Relat Res 1975; 109 (109) 178-183
    CrossrefPubMedGoogle Scholar
  • 10 Rangger C, Klestil T, Gloetzer W, Kemmler G, Benedetto KP. Osteoarthritis after arthroscopic partial meniscectomy. Am J Sports Med 1995; 23 (2) 240-244
    Google Scholar
  • 11 Lee SJ, Aadalen KJ, Malaviya P , et al. Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med 2006; 34 (8) 1334-1344
    CrossrefPubMedGoogle Scholar
  • 12 Alhalki MM, Hull ML, Howell SM. Contact mechanics of the medial tibial plateau after implantation of a medial meniscal allograft. A human cadaveric study. Am J Sports Med 2000; 28 (3) 370-376
    PubMedGoogle Scholar
  • 13 Paletta Jr GA, Manning T, Snell E, Parker R, Bergfeld J. The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee. A biomechanical study. Am J Sports Med 1997; 25 (5) 692-698
    CrossrefPubMedGoogle Scholar
  • 14 Cole BJ, Carter TR, Rodeo SA. Allograft meniscal transplantation. Background, techniques, and results. J Bone Joint Surg 2002; 84: 1236-1250
    PubMedGoogle Scholar
  • 15 van Arkel ER, Wilmes P. Meniscus transplantation; the Dutch experience. Orthop Traumatol Surg Res 2009; 95 (8, Suppl 1) S70-S71
    PubMedGoogle Scholar
  • 16 Goble EM, Kohn D, Verdonk R, Kane SM. Meniscal substitutes—human experience. Scand J Med Sci Sports 1999; 9 (3) 146-157
    PubMedGoogle Scholar
  • 17 Peters G, Wirth CJ. The current state of meniscal allograft transplantation and replacement. Knee 2003; 10 (1) 19-31
    CrossrefPubMedGoogle Scholar
  • 18 Garrett JC, Steensen RN. Meniscal transplantation in the human knee: a preliminary report. Arthroscopy 1991; 7 (1) 57-62
    PubMedGoogle Scholar
  • 19 Cole BJ, Dennis MG, Lee SJ , et al. Prospective evaluation of allograft meniscus transplantation: a minimum 2-year follow-up. Am J Sports Med 2006; 34 (6) 919-927
    CrossrefPubMedGoogle Scholar
  • 20 Milachowski KA, Weismeier K, Wirth CJ. Homologous meniscus transplantation. Experimental and clinical results. Int Orthop 1989; 13 (1) 1-11
    PubMedGoogle Scholar
  • 21 Noyes FR, Barber-Westin SD, Rankin M. Meniscal transplantation in symptomatic patients less than fifty years old. J Bone Joint Surg Am 2005; 87 (Pt 2, Suppl 1) 149-165
    CrossrefPubMedGoogle Scholar
  • 22 Pollard ME, Kang Q, Berg EE. Radiographic sizing for meniscal transplantation. Arthroscopy 1995; 11 (6) 684-687
    CrossrefPubMedGoogle Scholar
  • 23 Shelton WR, Dukes AD. Meniscus replacement with bone anchors: a surgical technique. Arthroscopy 1994; 10 (3) 324-327
    PubMedGoogle Scholar
  • 24 Cole BJ, Fox JA, Lee SJ, Farr J. Bone bridge in slot technique for meniscal transplantation. Oper Tech Sports Med 2003; 11: 144-155
    CrossrefPubMedGoogle Scholar
  • 25 Goble E, Kane S, Wilcox T, Doucette S. Meniscal allografts. In: McGinty J, Caspari R, Jackson R, Poehling G, eds. Operative Arthroscopy. Philadelphia, PA: Lippincott-Raven; 1996: 317-331
    Google Scholar
  • 26 Ware J, Kosinski M, Turner-Bowker D, Gandek B. How to Score Version 2 of the SF-12 Health Survey. Lincoln, RI: Quality Metric Incorporated; 2002
    Google Scholar
  • 27 Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 1982; 10 (3) 150-154
    CrossrefPubMedGoogle Scholar
  • 28 Anderson A. Rating scales. In: Fu F, Harner C, Vince K, eds. Knee Surgery. Baltimore, MD: Williams & Wilkins; 1994: 275-296
    Google Scholar
  • 29 Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 1998; 28 (2) 88-96
    CrossrefPubMedGoogle Scholar
  • 30 Cameron JC, Saha S. Meniscal allograft transplantation for unicompartmental arthritis of the knee. Clin Orthop Relat Res 1997; 337 (337) 164-171
    CrossrefPubMedGoogle Scholar
  • 31 Carter TR. Meniscal allograft transplantation. Sports Med Arthrosc Rev 1999; 7: 51-62
    CrossrefPubMedGoogle Scholar
  • 32 Rath E, Richmond JC, Yassir W, Albright JD, Gundogan F. Meniscal allograft transplantation. Two- to eight-year results. Am J Sports Med 2001; 29 (4) 410-414
    CrossrefPubMedGoogle Scholar
  • 33 Sekiya JK, West RV, Groff YJ, Irrgang JJ, Fu FH, Harner CD. Clinical outcomes following isolated lateral meniscal allograft transplantation. Arthroscopy 2006; 22 (7) 771-780
    CrossrefPubMedGoogle Scholar
  • 34 Sekiya JK, Giffin JR, Irrgang JJ, Fu FH, Harner CD. Clinical outcomes after combined meniscal allograft transplantation and anterior cruciate ligament reconstruction. Am J Sports Med 2003; 31 (6) 896-906
    PubMedGoogle Scholar
  • 35 van Arkel ER, de Boer HH. Survival analysis of human meniscal transplantations. J Bone Joint Surg Br 2002; 84 (2) 227-231
    CrossrefPubMedGoogle Scholar
  • 36 Yoldas EA, Sekiya JK, Irrgang JJ, Fu FH, Harner CD. Arthroscopically assisted meniscal allograft transplantation with and without combined anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2003; 11 (3) 173-182
    CrossrefPubMedGoogle Scholar
  • 37 Wirth CJ, Peters G, Milachowski KA, Weismeier KG, Kohn D. Long-term results of meniscal allograft transplantation. Am J Sports Med 2002; 30 (2) 174-181
    CrossrefPubMedGoogle Scholar
  • 38 Verdonk PC, Demurie A, Almqvist KF, Veys EM, Verbruggen G, Verdonk R. Transplantation of viable meniscal allograft. Survivorship analysis and clinical outcome of one hundred cases. J Bone Joint Surg Am 2005; 87 (4) 715-724
    CrossrefPubMedGoogle Scholar
  • 39 van der Wal RJ, Thomassen BJ, van Arkel ER. Long-term clinical outcome of open meniscal allograft transplantation. Am J Sports Med 2009; 37 (11) 2134-2139
    CrossrefPubMedGoogle Scholar