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Review
. 2009 Jul;91(5):361-5.
doi: 10.1308/003588409X428559. Epub 2009 Apr 30.

Meniscal allograft transplantation: a review of the current literature

T B Crook  1 , A Ardolino, L A P Williams, I W Barlow
Affiliations
Review

Meniscal allograft transplantation: a review of the current literature

T B Crook et al. Ann R Coll Surg Engl. 2009 Jul.

Abstract

Introduction: Patients who have previously undergone meniscectomy are known to potentially suffer subsequent knee problems including degenerative changes. Meniscal transplantation has been proposed as a possible solution to these problems. This article aims to review the current literature to consolidate the evidence surrounding the use of human meniscal allograft transplantation.

Materials and methods: Three databases (PubMed, Embase and Medline) were searched to find English language articles pertaining to meniscal allograft transplantation. Each article was critiqued by two authors using a structured appraisal tool, and stratified according to the level of evidence.

Results: No Level I or II studies were identified. Many studies had small study groups with limited follow-up and patient selection and description of patient factors varied greatly. This made comparing data difficult. There were also very few papers concentrating on isolated meniscal transplantation. Four types of graft are used--fresh, fresh-frozen, cryopreserved and freeze-dried (lyophilised) graft. Cryopreserved and fresh-frozen allografts are deemed most suitable. Most authors advocate the use of non-irradiated grafts from screened donors to reduce transmission of infection. Best results occur when using bony anchors to fix the graft, although this requires accurate graft positioning. Patients have an improved outcome if they have less severe degenerative changes within the knee prior to transplantation.

Conclusions: No statistically significant studies looking at isolated meniscal transplantations have been found. The evidence suggests that meniscal allograft transplantation provides improvement of pain and function in the short and intermediate term. The effect on future joint degeneration is still unknown. The ideal patient group includes patients less than 40 years of age with knee pain, proven meniscal injury and a normally aligned, stable joint without severe degenerative changes.

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Figures

Figure 1
Figure 1
The use of two bony plugs attached to each horn of the medial meniscus.
Figure 2
Figure 2
The use of one bony plug attached to both horns of the lateral meniscus.
See this image and copyright information in PMC

References

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