João V Novaretti1, Neel K Patel2, Jayson Lian3, Ravi Vaswani2, Darren de Sa2, Alan Getgood4, Volker Musahl5. 1. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.; Orthopaedics and Traumatology Sports Center (CETE), Department of Orthopaedics and Traumatology, Paulista School of Medicine (EPM), Federal University of São Paulo, São Paulo, Brazil. 2. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A. 3. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.; Albert Einstein College of Medicine, Bronx, New York, U.S.A. 4. Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada. 5. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.. Electronic address: musahlv@upmc.edu.
Abstract
PURPOSE: To investigate the long-term survivorship rates and functional outcomes of meniscal allograft transplantation (MAT) in patients with minimum 10-year postoperative follow-up. METHODS: Two reviewers independently searched EMBASE, MEDLINE, and PubMed from database inception for literature related to MAT according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Data are reported in a narrative summary fashion with descriptive statistics. RESULTS: Eleven studies with a total of 658 patients and 688 MATs were included. Mean age of patients was 33.1 years (range 14-66), of whom 63% were male. Mean survivorship rates were 73.5% at 10-year and 60.3% at 15-year follow-up, with 2 studies reporting 19- and 24-year survivorship of 50% and 15.1%, respectively. Pre- and postoperative Lysholm scores ranged from 36 to 60.5 and 61 to 75, respectively. Pre- and postoperative Tegner scores ranged from 1 to 3 and 2.5 to 4.6, respectively. Postoperative Knee injury and Osteoarthritis Outcome Score subset scores were as follows: Pain: 61.6 to 76.3; Symptoms: 57.9 to 61.8; Function in Daily Living: 68.5 to 79.9; Sport and Recreation: 33.9 to 49.3; Quality of Life: 37.3 to 45.9. Postoperative International Knee Documentation Committee scores ranged from 46 to 77. Regarding surgical technique, 194 MAT bone-fixation technique (53.8%) and 165 MAT suture-only fixation techniques (46.2%) were reported. The most common type of allograft used was cryopreserved (54.5% of the allografts). The most frequent concomitant procedures performed with MAT were to address chondral (20.8% of the cases) and ligament injuries (12.4% of the cases), and realignment procedures (9.4% of the cases). The most common complications observed that were not directly related to concomitant procedures were meniscal allograft partial tears (11.1%), arthrofibrosis (3.6%), and infection (2.0%). Several criteria were used among studies to define failure of MAT, the most common parameters being removal of meniscal allograft (8/11 studies) and conversion to total knee arthroplasty (7/11 studies). CONCLUSIONS: MAT can yield good long-term survivorship rates, with 73.5% and 60.3% of allografts remaining functional after 10 and 15 years, respectively. Functional outcomes 10 years after MAT were fair and improved compared with preoperative scores. LEVEL OF EVIDENCE: Level IV, systematic review of Level III and IV studies.
PURPOSE: To investigate the long-term survivorship rates and functional outcomes of meniscal allograft transplantation (MAT) in patients with minimum 10-year postoperative follow-up. METHODS: Two reviewers independently searched EMBASE, MEDLINE, and PubMed from database inception for literature related to MAT according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Data are reported in a narrative summary fashion with descriptive statistics. RESULTS: Eleven studies with a total of 658 patients and 688 MATs were included. Mean age of patients was 33.1 years (range 14-66), of whom 63% were male. Mean survivorship rates were 73.5% at 10-year and 60.3% at 15-year follow-up, with 2 studies reporting 19- and 24-year survivorship of 50% and 15.1%, respectively. Pre- and postoperative Lysholm scores ranged from 36 to 60.5 and 61 to 75, respectively. Pre- and postoperative Tegner scores ranged from 1 to 3 and 2.5 to 4.6, respectively. Postoperative Knee injury and Osteoarthritis Outcome Score subset scores were as follows: Pain: 61.6 to 76.3; Symptoms: 57.9 to 61.8; Function in Daily Living: 68.5 to 79.9; Sport and Recreation: 33.9 to 49.3; Quality of Life: 37.3 to 45.9. Postoperative International Knee Documentation Committee scores ranged from 46 to 77. Regarding surgical technique, 194 MAT bone-fixation technique (53.8%) and 165 MAT suture-only fixation techniques (46.2%) were reported. The most common type of allograft used was cryopreserved (54.5% of the allografts). The most frequent concomitant procedures performed with MAT were to address chondral (20.8% of the cases) and ligament injuries (12.4% of the cases), and realignment procedures (9.4% of the cases). The most common complications observed that were not directly related to concomitant procedures were meniscal allograft partial tears (11.1%), arthrofibrosis (3.6%), and infection (2.0%). Several criteria were used among studies to define failure of MAT, the most common parameters being removal of meniscal allograft (8/11 studies) and conversion to total knee arthroplasty (7/11 studies). CONCLUSIONS:MAT can yield good long-term survivorship rates, with 73.5% and 60.3% of allografts remaining functional after 10 and 15 years, respectively. Functional outcomes 10 years after MAT were fair and improved compared with preoperative scores. LEVEL OF EVIDENCE: Level IV, systematic review of Level III and IV studies.
Authors: M K Bartolo; E Provaggi; K K Athwal; S Newman; M A Accardi; D Dini; A Williams; A A Amis Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-10-19 Impact factor: 4.114
Authors: Luca Macchiarola; Stefano Di Paolo; Alberto Grassi; Giacomo Dal Fabbro; Gian Andrea Lucidi; Ilaria Cucurnia; Stefano Zaffagnini Journal: Orthop J Sports Med Date: 2021-05-21