PURPOSE: The primary objective of this study was to perform an updated systematic review and meta-analysis of meniscal allograft transplantation using patient reported outcome measures at final follow-up as the outcome tool. The secondary objective was to provide an up to date review of the indications, associated procedures, operative technique, rehabilitation, failures, complications, radiological outcomes, and graft healing. METHODS: Medline, Embase and CENTRAL databases, trials registries, and Web-of Science were searched for studies using pre-defined eligibility criteria. Included studies were reviewed with Lysholm, International Knee Documentation Committee (IKDC) and Tegner scores, failures and complications pooled. Studies were also qualitatively assessed. RESULTS: There were 1,332 patients (1,374 knees) in 35 studies eligible for analysis. The mean follow-up was 5.1 years. Across all studies, Lysholm scores improved from 55.7 to 81.3, IKDC scores from 47.0 to 70.0, and Tegner activity scores from 3.1 to 4.7 between pre-operative and final follow-up assessments, respectively. The mean failure rate across all studies was 10.6% at 4.8 years, and complication rate was 13.9% at 4.7 years. There is a high risk of bias across the studies due to study design and missing outcomes. CONCLUSION: Based on current evidence, meniscal allograft transplantation appears to be an effective intervention for patients with a symptomatic meniscal deficient knee. This should ideally be confirmed with a randomised controlled trial. There is not currently enough evidence to determine whether it is chondroprotective.
PURPOSE: The primary objective of this study was to perform an updated systematic review and meta-analysis of meniscal allograft transplantation using patient reported outcome measures at final follow-up as the outcome tool. The secondary objective was to provide an up to date review of the indications, associated procedures, operative technique, rehabilitation, failures, complications, radiological outcomes, and graft healing. METHODS: Medline, Embase and CENTRAL databases, trials registries, and Web-of Science were searched for studies using pre-defined eligibility criteria. Included studies were reviewed with Lysholm, International Knee Documentation Committee (IKDC) and Tegner scores, failures and complications pooled. Studies were also qualitatively assessed. RESULTS: There were 1,332 patients (1,374 knees) in 35 studies eligible for analysis. The mean follow-up was 5.1 years. Across all studies, Lysholm scores improved from 55.7 to 81.3, IKDC scores from 47.0 to 70.0, and Tegner activity scores from 3.1 to 4.7 between pre-operative and final follow-up assessments, respectively. The mean failure rate across all studies was 10.6% at 4.8 years, and complication rate was 13.9% at 4.7 years. There is a high risk of bias across the studies due to study design and missing outcomes. CONCLUSION: Based on current evidence, meniscal allograft transplantation appears to be an effective intervention for patients with a symptomatic meniscal deficient knee. This should ideally be confirmed with a randomised controlled trial. There is not currently enough evidence to determine whether it is chondroprotective.
Authors: Jon K Sekiya; J Robert Giffin; James J Irrgang; Freddie H Fu; Christopher D Harner Journal: Am J Sports Med Date: 2003 Nov-Dec Impact factor: 6.202
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