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This Article Full Text Full Text (PDF) All Versions of this Article: 34/6/919    most recent 0363546505284235v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Cole, B. J. Articles by Verma, N. N. Search for Related Content PubMed PubMed Citation Articles by Cole, B. J. Articles by Verma, N. N. Related Collections Chondral/cartilage Meniscus

Prospective Evaluation of Allograft Meniscus Transplantation

A Minimum 2-Year Follow-up

From the Rush Cartilage Restoration Center, Section of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College, Rush-Presbyterian-St Luke’s Medical Center, Chicago, Illinois

^* Address correspondence to Brian J. Cole, MD, Rush Cartilage Restoration Center, Department of Orthopedic Surgery and Anatomy (Conjoint), Rush Medical College, Rush-Presbyterian-St Luke’s Medical Center, 1725 West Harrison Street, Suite 1063, Chicago, IL 60612 (e-mail: bcole{at}ortho4.pro.rpslmc.edu).

Background: Clinical and biomechanical studies have demonstrated the increase in contact pressure and progressive deterioration of the tibiofemoral compartments that occur after partial or complete meniscectomy. Meniscus transplantation has been indicated for the symptomatic postmeniscectomy patient to alleviate symptoms and potentially prevent the progression of articular degeneration.

Purpose: To report the early-term results after allograft meniscus transplantations from a single institution performed by a single surgeon.

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

Methods: Forty-four meniscus transplants in 39 patients were evaluated at minimum 2-year follow-up using the Lysholm, Tegner, International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score, Noyes symptom rating and sports activity, and SF-12 scoring systems; visual analog pain scales; patient satisfaction; and physical examination. Four transplants failed early, leaving 40 transplants in 36 patients for review. Patients were grouped into medial and lateral transplant groups as well as those with isolated and combined procedures. Twenty-one menisci were transplanted in isolation (52.5%), and 19 were combined with other procedures (47.5%) to address concomitant articular cartilage injury.

Results: Patients demonstrated statistically significant improvements in standardized outcomes surveys and visual analog pain and satisfaction scales. In 7 patients, treatment had failed at final follow-up. Overall, 77.5% of patients reported they were completely or mostly satisfied with the procedure, and 90% of patients were classified as normal or nearly normal using the International Knee Documentation Committee knee examination score at final follow-up. There were no significant differences in the medial and lateral subgroups, although the lateral subgroup did demonstrate a trend toward greater improvement. No significant differences were noted in the isolated and combined subgroups.

Conclusion: Meniscus transplantation alone or in combination with other reconstructive procedures results in reliable improvements in knee pain and function at minimum 2-year follow-up. Longer term studies are necessary to determine if transplantation can prevent the articular degeneration associated with meniscectomy.

Key Words: meniscus • meniscus transplant • meniscectomy

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