Risk Factors for Radiographic Progression of Osteoarthritis After Meniscus Allograft Transplantation

Abstract

Purpose: To identify risk factors that predict radiographic progression of osteoarthritis after meniscus allograft transplantation (MAT) using multivariate logistic regression.

Methods: Inclusion criteria were consecutive patients who underwent medial or lateral MATs from January 2005 to September 2012 by one surgeon. Exclusion criteria were lack of postoperative magnetic resonance image, loss to follow-up for a minimum of 3 years, and simultaneous surgery on articular cartilage or the anterior cruciate ligament. According to the change of Kellgren-Lawrence (KL) grade at the mean final follow-up of 56.2 months, the enrolled MATs were sorted into the no progression of osteoarthritis (NOA) and progression of osteoarthritis (POA) groups. Multivariate logistic regression was used to analyze risk factors, including age, sex, body mass index, time from previous meniscectomy to MAT, extent of previous meniscectomy, previous anterior cruciate ligament reconstruction, knee alignment angle, KL grade, side of transplanted meniscus, Outerbridge grade, posterior repair technique, and relative percentage of extrusion.

Results: In comparison between the NOA (n = 38) and the POA (n = 31) groups, a significant risk factor for radiographic progression of osteoarthritis after MAT was medial MAT compared with lateral MAT. Medial MAT compared with lateral MAT was also a significant risk factor (adjusted odds ratio, 3.763; 95% confidence interval, 1.212-11.683).

Conclusions: Patients need to be counseled about the increased risk of osteoarthritis progression after MAT over time, particularly for medial MAT.

Level of evidence: Level III, retrospective case control study.