Open Meniscal Allograft Transplantation With Transosseous Suture Fixation of the Meniscal Body Significantly Decreases Meniscal Extrusion Rate Compared With Arthroscopic Technique

2019 ◽  
Vol 35 (6) ◽  
pp. 1658-1666 ◽  
Author(s):  
Gergo Merkely ◽  
Takahiro Ogura ◽  
Jakob Ackermann ◽  
Alexandre Barbieri Mestriner ◽  
Tom Minas ◽  
...  
Keyword(s):  
Suture Fixation ◽  
Meniscal Extrusion ◽  
Meniscal Allograft Transplantation ◽  
Arthroscopic Technique ◽  
Extrusion Rate ◽  
Transosseous Suture ◽  
Allograft Transplantation ◽  
Meniscal Allograft

scholarly journals Meniscus allograft transplantation: indications, techniques and outcomes

2019 ◽  
Vol 4 (4) ◽  
pp. 115-120 ◽  
Author(s):  
Francisco Figueroa ◽  
David Figueroa ◽  
Rafael Calvo ◽  
Alex Vaisman ◽  
João Espregueira-Mendes
Keyword(s):  
Low Grade ◽  
Meniscal Extrusion ◽  
Meniscus Allograft Transplantation ◽  
Meniscal Allograft Transplantation ◽  
Chondral Lesions ◽  
Allograft Transplantation ◽  
Meniscal Allograft ◽  
Meniscus Allograft ◽  
Sports Activities

New indications for meniscal allograft transplantation (MAT) are being added, but the general expert opinion is that it is still a procedure reserved for symptomatic meniscal loss. Lateral MAT has better clinical outcomes and less failure risk compared to medial MAT. Ideal conditions (low-grade chondral lesions) make MAT a more survivable and successful procedure. Meniscal extrusion after MAT is common and does not seem to alter results. Midterm survivorship of a MAT is reported to be 85–90%, while long-term survivorship decreases to 50–70% depending on chondral status and concomitant procedures. Even if the procedure is a success, there are high possibilities of not being able to resume sports activities. Cite this article: EFORT Open Rev 2019;4:115-120. DOI: 10.1302/2058-5241.4.180052

Meniscal Deficiency Period and High Body Mass Index Are Preoperative Risk Factors for Joint Space Narrowing After Meniscal Allograft Transplantation

2021 ◽  
Vol 49 (3) ◽  
pp. 693-699
Author(s):  
Sang-Min Lee ◽  
Seong-Il Bin ◽  
Jong-Min Kim ◽  
Bum-Sik Lee ◽  
Kuen Tak Suh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Condyle ◽  
Joint Space ◽  
Preoperative Risk ◽  
Meniscal Allograft Transplantation ◽  
Time Points ◽  
Allograft Transplantation ◽  
Preoperative Risk Factors ◽  
Meniscal Allograft ◽  
The Difference

Background: Several studies have reported further reduction in joint space width (JSW) after meniscal allograft transplantation; some contributing postoperative factors are known, although preoperative factors remain unclear. This study is the first to analyze the preoperative risk factors for reduced JSW in patients after lateral meniscal allograft transplantation (LMAT). Hypothesis: Poor cartilage status and high preoperative body mass index (BMI) influence the postoperative progression of joint space narrowing. Study Design: Case-control study; Level of evidence, 3. Methods: We retrospectively studied 79 patients after LMAT who were observed for at least 5 years. JSWs on weightbearing flexion posteroanterior radiographs were measured preoperatively and at the 5-year mark. Differences in JSW were divided into more progression and less progression groups. The modified Outerbridge cartilage grades based on magnetic resonance imaging assessments were compared at subtotal/total meniscectomy and at LMAT to determine the difference between time points. Preoperative between-group differences in sex, age, surgical side, follow-up period, weight, height, BMI, and meniscal deficiency period were analyzed. Clinical outcomes were evaluated using the Lysholm score. Data were examined using univariate and multivariate logistic regressions. Results: Radiographically, the overall change in JSW from preoperative to follow-up was 0.58 mm (range, –0.23 to 1.83 mm). Reductions in JSW in the more progression and less progression groups were 0.94 ± 0.32 and 0.22 ± 0.21 mm (mean ± SD), respectively. There was no difference in cartilage status between the groups at meniscectomy or LMAT; however, changes between time points were significant on the lateral femoral condyle and lateral tibial plateau. Clinically, there were significant differences in weight, BMI, and meniscal deficiency period between the 2 groups. Postoperative Lysholm scores increased as compared with the preoperative scores, but there was no difference among the postoperative time points. In the univariate logistic regression risk analysis, weight, BMI, meniscal deficiency period, and the difference in cartilage status between time points for the lateral femoral condyle and lateral tibial plateau were identified as significant. In the subsequent multivariate logistic regression, BMI (odds ratio, 1.45; P = .016) and meniscal deficiency period (odds ratio, 1.21; P = .037) were the statistically significant factors. Conclusion: BMI and meniscal deficiency period were preoperative risk factors for JSW narrowing after LMAT. This suggests that the meniscal deficiency period from meniscectomy to LMAT may be shortened and that proper weight management can lead to successful LMAT.

scholarly journals THE EPIDEMIOLOGY OF PEDIATRIC MENISCAL ALLOGRAFT TRANSPLANTATION IN THE UNITED STATES

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
Haley E. Smith ◽  
Madeline M. Lyons ◽  
Neeraj M. Patel
Keyword(s):  
United States ◽  
Pediatric Population ◽  
The United States ◽  
National Database ◽  
Control Group ◽  
Meniscal Allograft Transplantation ◽  
Children's Hospitals ◽  
Allograft Transplantation ◽  
Meniscal Allograft ◽  
Children’S Hospitals

Background: Meniscal allograft transplantation (MAT) is an option to slow the progression of degenerative disease in the setting of substantial meniscal deficiency. This may be especially important in children and adolescents, but there is little literature on MAT in this population. Hypothesis/Purpose: The purpose of this study was to evaluate the epidemiology of MAT in the pediatric population, with specific attention to regional and demographic trends. Methods: The Pediatric Health Information System, a national database consisting of 49 children’s hospitals, was queried for all patients undergoing MAT between 2011 and 2018. Demographic information was collected for each subject as well as data regarding previous and subsequent surgeries. The database was also queried for all meniscus surgeries (including repairs and meniscectomies) performed during the study period. Demographic and geographic data from this control group were compared to that of children undergoing MAT. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 27,168 meniscus surgeries were performed in 47 hospitals, with MAT performed 67 times in 17 hospitals. Twelve patients (18%) underwent a subsequent procedure after transplantation. In multivariate analysis, each year of increasing age resulted in 1.1 times higher odds of having undergone MAT rather than repair or meniscectomy (95% CI 1.03-1.1, p=0.002). Patients that underwent transplantation had 2.0 times higher odds of being female (95% CI 1.2-3.3, p=0.01) and 2.0 times higher odds of being commercially insured (95% CI 1.1-3.6, p=0.02). MAT was performed most frequently in the Northeast (4.9/1000 meniscus surgeries) and least often in the South (1.1/1000 meniscus surgeries, p<0.001). Furthermore, transplantation was more likely to be performed in larger cities. The median pediatric population of cities in which MAT was performed was 983,268 (range 157,253-3,138,870) compared to 662,290 (range 4,420-4,311,500) in cities where it was not (p=0.04). Conclusion: In the United States, patients that underwent MAT were older, more likely to be female, and have commercial insurance than those undergoing meniscus repair or meniscectomy. MAT was only done in 17/47 children’s hospitals that perform meniscus surgery and was most frequently performed in the Northeast and in larger cities. These trends highlight the need for further research, especially regarding differences along the lines of sex and insurance status.

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