Outcomes, Complications, and Reoperations After Meniscal Allograft Transplantation

Abstract

Background: Outcomes following meniscal allograft transplantation (MAT) are an evolving topic.

Purpose: To review clinical outcomes in younger, previously active patients who underwent an isolated MAT or MAT plus any osteotomy. Concurrent surgeries, complications, and graft survivorship are presented.

Study design: Case series; Level of evidence, 4.

Methods: Inclusion criteria included having undergone MAT with a minimum of 1 year of follow-up with at least 1 of the following patient-reported outcome (PRO) measures collected pre- and postoperatively: visual analog scale for pain, Knee injury and Osteoarthritis Outcome Score (KOOS), the Western Ontario and McMaster Universities Arthritis Index, the 36-Item Short Form Health Survey, and overall satisfaction. From patient records, we recorded descriptive data, side (medial/lateral), previous or concurrent procedures, perioperative complications, revisions, and conversion to arthroplasty. Two-factor analysis of variance (ANOVA) was used to test for differences in age and body mass index (BMI). A 2 × 2 chi-square test was used to determine if the spectrum of procedures performed on our study's patient group was representative of the entire population. PRO results were analyzed using a multivariate ANOVA.

Results: From a total of 91 eligible patients, 61 (63 knees) met our inclusion criteria. Mean presurgery age was 25.5 ± 9.2 years, and mean BMI was 26.7 (range, 18.5-38.4). At follow-up (mean, 4.8 years; range, 1.0-13.6 years) overall PROs were statistically and clinically improved at final follow-up (P ≤ .003); effect sizes were moderate and large. KOOS Pain and KOOS Activities of Daily Living showed some main or interaction effects that were trivial or small. Patient satisfaction with the treatment was ≥7 out of 10 in 85% of patients. A minimum of 1 subsequent surgery for various concerns was necessary in 23% of the 93 knees. Graft survival in the included patients was 100%.

Conclusion: Complications (conditions requiring at least 1 subsequent surgery) affected about one-quarter of the patients who underwent MAT. Nevertheless, MAT seemed to provide our patients with adequate pain relief and improved function.

Keywords: allograft; meniscal allograft transplantation; meniscectomy; postmeniscectomy syndrome; transplantation.

Figure 1.

Flow diagram of the patient selection process. PRO, patient-reported outcome.