Skip to main content

Advertisement

Log in

Meniscal allograft transplantation in isolated and combined surgery

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to report the initial results of meniscus allograft transplantation after a 2-year follow-up period with second-look arthroscopy of 18 patients.

Methods

Seven medial and 11 lateral meniscus allografts were evaluated with a median follow-up of 24.9 months (range, 18–41 months). The clinical outcome and failure rate were evaluated by use of second-look arthroscopy in all patients, magnetic resonance imaging (MRI) analysis in 17 patients, and standardized outcome scores assessment, including Lysholm score, Knee Injury, and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS) on pain and satisfaction and International Knee Documentation Committee (IKDC) objective ratings in all patients. Patients were grouped into medial and lateral subgroups as well as those with isolated or combined procedures.

Results

For the second-look arthroscopic findings, 6 meniscus transplants (33%) had normal characteristics, 10 (56%) had altered characteristics, and 2 (11%) failed. On MRI, two grafts had grade III signals and 11 showed partially extruded. Patients demonstrated statistically significant improvements in standardized outcome scores and VAS pain scales. Overall, 67% of the patients reported that they were completely or mostly satisfied with the procedure. There were no significant differences in the medial and lateral subgroups and no significant differences were noted in the isolated and combined subgroups.

Conclusions

Arthroscopic meniscus transplantation can achieve satisfying subjective and objective clinical outcomes, with a failure rate of 11% after 1–3 years of follow-up, as documented by second-look arthroscopy.

Level of evidence

Case series with no comparison group, Level IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Bhosale AM, Myint P, Roberts S et al (2007) Combined autologous chondrocyte implantation and allogenic meniscus transplantation: a biological knee replacement. Knee 14:361–368

    Article  PubMed  CAS  Google Scholar 

  2. Breitenseher MJ, Trattnig S, Dobrocky I et al (1997) MR imaging of meniscal subluxation in the knee. Acta Radiol 38:876–879

    PubMed  CAS  Google Scholar 

  3. Cole BJ, Carter TR, Rodeo SA (2003) Allograft meniscal transplantation: background, techniques, and results. Instr Course Lect 52:383–396

    PubMed  Google Scholar 

  4. Cole BJ, Dennis MG, Lee SJ et al (2006) Prospective evaluation of allograft meniscus transplantation: a minimum 2-year follow-up. Am J Sports Med 34:919–927

    Article  PubMed  Google Scholar 

  5. Dandy DJ, Jackson RW (1975) Meniscectomy and chondromalacia of the femoral condyle. J Bone Joint Surg Am 57:1116–1119

    PubMed  CAS  Google Scholar 

  6. Elattar M, Dhollander A, Verdonk R et al (2011) Twenty-six years of meniscal allograft transplantation: is it still experimental? A meta-analysis of 44 trials. Knee Surg Sports Traumatol Arthrosc 19:147–157

    Article  PubMed  Google Scholar 

  7. Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Joint Surg Br 30B:664–670

    PubMed  CAS  Google Scholar 

  8. Farr J, Rawal A, Marberry KM (2007) Concomitant meniscal allograft transplantation and autologous chondrocyte implantation: minimum 2-year follow-up. Am J Sports Med 35:1459–1466

    Article  PubMed  Google Scholar 

  9. Graf KW, Sekiya JK, Wojtys EM (2004) Long-term results after combined medial meniscal allograft transplantation and anterior cruciate ligament reconstruction: minimum 8.5-year follow-up study. Arthroscopy 20:129–140

    PubMed  Google Scholar 

  10. Harris JD, Cavo M, Brophy R et al (2010) Biological knee reconstruction: a systematic review of combined meniscal allograft transplantation and cartilage repair or restoration. Arthroscopy. doi:10.1016/j.arthro.2010.08.007

    Google Scholar 

  11. Hergan D, Thut D, Sherman O et al (2010) Meniscal allograft transplantation. Arthroscopy. doi:10.1016/j.arthro.2010.05.019

    PubMed  Google Scholar 

  12. Johnson RJ, Kettelkamp DB, Clark W et al (1974) Factors effecting late results after meniscectomy. J Bone Joint Surg Am 56:719–729

    PubMed  CAS  Google Scholar 

  13. Kim JM, Bin SI (2006) Meniscal allograft transplantation after total meniscectomy of torn discoid lateral meniscus. Arthroscopy 22:1344–13501

    Article  PubMed  Google Scholar 

  14. Klimkiewicz JJ, Shaffer B (2002) Meniscal surgery 2002 update: indications and techniques for resection, repair, regeneration, and replacement. Arthroscopy 18:14–25

    PubMed  Google Scholar 

  15. Lee JH, Lim YJ, Kim KB et al (2009) Arthroscopic pullout suture repair of posterior root tear of the medial meniscus: radiographic and clinical results with a 2-year follow-up. Arthroscopy 25:951–958

    Article  PubMed  Google Scholar 

  16. Milachowski KA, Weismeier K, Wirth CJ (1989) Homologous meniscus transplantation. Experimental and clinical results. Int Orthop 13:1–11

    Article  PubMed  CAS  Google Scholar 

  17. Noyes FR, Barber-Westin SD (2009) Noyes’ knee disorders: surgery, Rehabilitation, Clinical Outcoms. Elsevier, Philadelphia

    Google Scholar 

  18. Noyes FR, Barber-Westin SD, Rankin M (2004) Meniscal transplantation in symptomatic patients less than fifty years old. J Bone Joint Surg Am 86-A:1392–1404

    PubMed  Google Scholar 

  19. Pollard ME, Kang Q, Berg EE (1995) Radiographic sizing for meniscal transplantation. Arthroscopy 11:684–687

    Article  PubMed  CAS  Google Scholar 

  20. Rath E, Richmond JC, Yassir W et al (2001) Meniscal allograft transplantation. Two- to eight-year results. Am J Sports Med 29:410–414

    PubMed  CAS  Google Scholar 

  21. Rue JP, Yanke AB, Busam ML et al (2008) Prospective evaluation of concurrent meniscus transplantation and articular cartilage repair: minimum 2-year follow-up. Am J Sports Med 36:1770–1778

    Article  PubMed  Google Scholar 

  22. Shelton WR, Dukes AD (1994) Meniscus replacement with bone anchors: a surgical technique. Arthroscopy 10:324–327

    Article  PubMed  CAS  Google Scholar 

  23. Szomor ZL, Martin TE, Bonar F et al (2000) The protective effects of meniscal transplantation on cartilage. An experimental study in sheep. J Bone Joint Surg Am 82:80–88

    PubMed  CAS  Google Scholar 

  24. Thornton DD, Rubin DA (2000) Magnetic resonance imaging of the knee menisci. Semin Roentgenol 35:217–230

    Article  PubMed  CAS  Google Scholar 

  25. Verdonk PC, Demurie A, Almqvist KF et al (2005) Transplantation of viable meniscal allograft. Survivorship analysis and clinical outcome of one hundred cases. J Bone Joint Surg Am 87:715–724

    Article  PubMed  Google Scholar 

  26. Verdonk PC, Verstraete KL, Almqvist KF et al (2006) Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations. Knee Surg Sports Traumatol Arthrosc 14:694–706

    Article  PubMed  Google Scholar 

  27. von LG, Milachowski KA, Weismeier K et al (2007) Twenty-year results of combined meniscal allograft transplantation, anterior cruciate ligament reconstruction and advancement of the medial collateral ligament. Knee Surg Sports Traumatol Arthrosc 15:1072–1082

    Article  Google Scholar 

  28. Wirth CJ, Peters G, Milachowski KA et al (2002) Long-term results of meniscal allograft transplantation. Am J Sports Med 30:174–181

    PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interests.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hua Feng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhang, H., Liu, X., Wei, Y. et al. Meniscal allograft transplantation in isolated and combined surgery. Knee Surg Sports Traumatol Arthrosc 20, 281–289 (2012). https://doi.org/10.1007/s00167-011-1572-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-011-1572-3

Keywords

Navigation