Literature DB >> 21161170

Twenty-six years of meniscal allograft transplantation: is it still experimental? A meta-analysis of 44 trials.

Mohamed Elattar1, Aad Dhollander, René Verdonk, Karl Fredrik Almqvist, Peter Verdonk.   

Abstract

PURPOSE: since the first meniscal allograft transplantation in 1984, thousands of patients with postmeniscectomy symptoms have been treated by allograft replacement. This study aims the collection, presentation and meta-analysis of published trials reporting outcomes of meniscal allograft transplantation to establish its safety and reproducibility.
METHODS: a literature search was conducted and the abstracts of all English-language trials with a more than 6 months' clinical, radiological and/or histological follow-up in human subjects were reviewed. Forty-four trials representing 1,136 grafts in 1,068 patients were analyzed. To assess the methodological quality of the collected data, original and modified Coleman methodology scores were determined for all included papers.
RESULTS: the outcomes of 678 medial and 458 lateral grafts in 613 male, 265 female and 190 nondefined patients with a mean age of 34.8 years were presented. The outcome was assessed using 12 scoring systems, 4 imaging modalities, second-look arthroscopy and/or histological analysis. Whatever the follow-up period and the scoring system used, patients continuously showed clinical improvement. The average original Coleman scores were 45.9 ± 8.4 (range 25-59). The average modified Coleman scores were 43.7 ± 9.1 (range 24-62).
CONCLUSIONS: all studies reported a continuously satisfactory outcome with restoration of working capacity in these active patients. The complication and failure rates are considered acceptable by all authors. Salvage procedures included osteotomy and arthroplasty without secondary difficulties. Meniscal allograft transplantation can be considered as safe and reliable for the treatment of refractory postmeniscectomy symptoms in selected patients. LEVEL OF EVIDENCE: IV.

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Year:  2010        PMID: 21161170     DOI: 10.1007/s00167-010-1351-6

Source DB:  PubMed          Journal:  Knee Surg Sports Traumatol Arthrosc        ISSN: 0942-2056            Impact factor:   4.342


  62 in total

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Review 4.  Current status of allograft meniscal transplantation.

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6.  Arthroscopic, open partial, and total meniscectomy. A comparative study.

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7.  Meniscal allograft transplantation after total meniscectomy of torn discoid lateral meniscus.

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8.  Meniscus allograft survival in patients with moderate to severe unicompartmental arthritis: a 2- to 7-year follow-up.

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9.  Arthroscopically assisted meniscal allograft transplantation with and without combined anterior cruciate ligament reconstruction.

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10.  Clinical evaluation of arthroscopic-assisted allograft meniscal transplantation.

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  62 in total

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2.  Host serum is not indispensable in collagen performance in viable meniscal transplantation at 4-week incubation.

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3.  Meniscus transplantation.

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4.  Prospective comparative study between two different fixation techniques in meniscal allograft transplantation.

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6.  A new technique for arthroscopic meniscus transplant using soft tissue fixation and anatomical meniscal root reinsertion.

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Review 7.  Meniscal allograft transplantation. Part 2: systematic review of transplant timing, outcomes, return to competition, associated procedures, and prevention of osteoarthritis.

Authors:  Gonzalo Samitier; Eduard Alentorn-Geli; Dean C Taylor; Brian Rill; Terrence Lock; Vasilius Moutzouros; Patricia Kolowich
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Review 8.  Low-impact sports activities are feasible after meniscus transplantation: a systematic review.

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