Stefano Zaffagnini1, Alberto Grassi1, Luca Macchiarola1, Federico Stefanelli1, Vito Coco1, Maurilio Marcacci2, Luca Andriolo3, Giuseppe Filardo4. 1. II Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. 2. Department of Biomedical Sciences, Humanitas University, Humanitas Clinical and Research Center, Milan, Italy. 3. II Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. Electronic address: lucas.andriolo@gmail.com. 4. Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Abstract
PURPOSE: To evaluate the influence of age on midterm clinical outcomes and failures of meniscal allograft transplantation (MAT), aiming at investigating the efficacy of MAT in patients older than 50 years. METHODS: In this case-control study, data on patients older than 50 years (older MAT [O-MAT] group) with at least 5 years of follow-up and a matched-pair group of patients younger than 30 years of age (younger MAT [Y-MAT] group) were extracted from a database of MAT procedures, performed with arthroscopic implantation of fresh-frozen meniscal allograft without bone plugs. RESULTS: A matched-pair comparative analysis of midterm results and survival between 26 O-MAT patients and 26 Y-MAT patients was performed at a mean follow-up of 7.3 ± 2.2 years. All the clinical scores significantly improved from the baseline values in both the O-MAT and Y-MAT groups although with significantly lower scores in the O-MAT group. Two-thirds of O-MAT patients were able to return to a recreational level of sports activity. Only 2 patients in the O-MAT group underwent knee replacement, but the overall failure rate, also considering a clinical criterion, was 31% in the O-MAT group and 15% in the Y-MAT group (P = .3244). The mean survival time free from replacement or graft removal was 11.6 years in the O-MAT group and 12.3 years in the Y-MAT group (P = .691). CONCLUSIONS: MAT is able to provide symptom relief and functional improvement at midterm follow-up in patients older than 50 years although with inferior results and a higher failure rate compared with those younger than 30 years. MAT can be considered a viable option to treat patients older than 50 years. LEVEL OF EVIDENCE: Level III, case-control study.
PURPOSE: To evaluate the influence of age on midterm clinical outcomes and failures of meniscal allograft transplantation (MAT), aiming at investigating the efficacy of MAT in patients older than 50 years. METHODS: In this case-control study, data on patients older than 50 years (older MAT [O-MAT] group) with at least 5 years of follow-up and a matched-pair group of patients younger than 30 years of age (younger MAT [Y-MAT] group) were extracted from a database of MAT procedures, performed with arthroscopic implantation of fresh-frozen meniscal allograft without bone plugs. RESULTS: A matched-pair comparative analysis of midterm results and survival between 26 O-MATpatients and 26 Y-MATpatients was performed at a mean follow-up of 7.3 ± 2.2 years. All the clinical scores significantly improved from the baseline values in both the O-MAT and Y-MAT groups although with significantly lower scores in the O-MAT group. Two-thirds of O-MATpatients were able to return to a recreational level of sports activity. Only 2 patients in the O-MAT group underwent knee replacement, but the overall failure rate, also considering a clinical criterion, was 31% in the O-MAT group and 15% in the Y-MAT group (P = .3244). The mean survival time free from replacement or graft removal was 11.6 years in the O-MAT group and 12.3 years in the Y-MAT group (P = .691). CONCLUSIONS:MAT is able to provide symptom relief and functional improvement at midterm follow-up in patients older than 50 years although with inferior results and a higher failure rate compared with those younger than 30 years. MAT can be considered a viable option to treat patients older than 50 years. LEVEL OF EVIDENCE: Level III, case-control study.
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