A Prospective Outcomes Study of Meniscal Allograft Transplantation

LaPrade, Robert F.; Wills, Nicholas J.; Spiridonov, Stanislav I.; Perkinson, Scott G.

doi:10.1177/0363546510368133

Cited by 84 publications

(75 citation statements)

References 33 publications

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“…MMAT results in reduced patient pain, less activity-related effusions, and improved functional activities. 7,[17][18][19][20] After MMAT, LaPrade et al 7 reported a significant improvement in symptoms as measured with International Knee Documentation Committee subjective scores (preop 51.2, postop 68.2) and Cincinnati scores (preop 52.3, postop 73.2) after a minimum 2-year follow-up. Verdonk et al 18 reported a survival rate of isolated MMAT to be 72.4% at 10 years.…”

Section: Discussionmentioning

confidence: 99%

“…An arthroscopic evaluation should be performed to determine if the patient is a suitable candidate for MMAT in cases of doubtful indication. 7,8 Uncorrected joint comorbidities are contraindications to MMAT. Concomitant procedures such as joint alignment, ligament stabilization, and cartilage resurfacing will likely improve the survival of the graft, and are encouraged to be performed in the same surgical procedure or previous to the MMAT.…”

Section: Objective Diagnosismentioning

confidence: 99%

“…(blinded for review) include isolated medial knee pain with or without postactivity effusions after subtotal, total, or a functionally equivalent meniscectomy in patients with closed physes. 7 The physes must be closed to avoid causing a physeal arrest and alignment deformities. Obesity should be considered as a relative contraindication to performing a MMAT; some authors contraindicate this procedure in patients with a body mass index of more than 30, because it increases the load within the knee compartments, resulting in increased risk of allograft failure.…”

Section: Indications For Surgerymentioning

confidence: 99%

“…Patients who are candidates for a concurrent articular cartilage resurfacing procedure can be considered for an exemption. 7 …”

Section: Indications For Surgerymentioning

confidence: 99%

“…7,18 All patients should be informed that MMAT is likely not a curative procedure, but should function to delay cartilage wear and preserve the knee joint. Few long-term studies have reported the chondroprotective effects of the MMAT.…”

Section: 22mentioning

confidence: 99%

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Medial Meniscal Allograft Transplantation: The Bone Plug Technique

Dean

Olivetto

Chahla

et al. 2016

Arthroscopy Techniques

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The medial meniscus is crucial for knee homeostasis. Treating patients who have undergone a subtotal or total meniscectomy, or equivalent irreparable tear pattern, can be extremely challenging, especially in young, active patients. The importance of meniscal preservation has been reported by several authors. Meniscal repair is now widely accepted as the first surgical option for treating medial meniscal tears. Moreover, current guidelines recommend preserving as much meniscal tissue as possible. Treating a symptomatic medial meniscectomized knee is challenging because of limited surgical options. In this context, medial meniscal allograft transplantation arises as the preferred procedure. The purpose of this article was to detail the arthroscopic medial meniscal allograft transplantation technique with the use of 2 bone plugs.

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Section: Discussionmentioning

confidence: 99%

Section: Objective Diagnosismentioning

confidence: 99%

Section: Indications For Surgerymentioning

confidence: 99%

“…Patients who are candidates for a concurrent articular cartilage resurfacing procedure can be considered for an exemption. 7 …”

Section: Indications For Surgerymentioning

confidence: 99%

Section: 22mentioning

confidence: 99%

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Medial Meniscal Allograft Transplantation: The Bone Plug Technique

Dean

Olivetto

Chahla

et al. 2016

Arthroscopy Techniques

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Intraarticular injection of synovial stem cells promotes meniscal regeneration in a rabbit massive meniscal defect model

Hatsushika

Muneta

Horie

et al. 2013

Journal Orthopaedic Research

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We investigated whether single intraarticular injection of synovial MSCs enhanced meniscal regeneration in a rabbit massive meniscal defect model. Synovium were harvested from the knee joint of rabbits, and the colony-forming cells were collected. Two weeks after the anterior half of the medial menisci were excised in both knees, 1 Â 10 7 MSCs in 100 ml PBS were injected into the right knee. The MSC and control groups were compared macroscopically and histologically at 1, 3, 4, and 6 months (n ¼ 4). Articular cartilage of the medial femoral condyle was also evaluated histologically at 6 months. Multipotentiality of the colony-forming cells was confirmed. Injected MSCs labeled with DiI were detected and remained in the meniscal defect at 14 days. The size of meniscus in the MSC group was larger than that in the control group at 1 and 3 months. The difference of the size between the two groups was indistinct at 4 and 6 months. However, histological score was better in the MSC group than in the control group at 1, 3, 4, and 6 months. Macroscopically, the surface of the medial femoral condyle in the control group was fibrillated at 6 months, while looked close to intact in the MSC group. Histologically, defect or thinning of the articular cartilage with sclerosis of the subchondral bone was observed in the control group, contrarily articular cartilage and subchondral bone were better preserved in the MSC group. Synovial MSCs injected into the knee adhered around the meniscal defect, and promoted meniscal regeneration in rabbits. ß

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Meniscus tears accelerate joint space loss and lateral meniscal extrusion increases risk of knee arthroplasty in middle‐aged adults

Everhart

Magnussen

Abouljoud

et al. 2020

Journal Orthopaedic Research

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We sought to use publicly available data from the Osteoarthritis Initiative (OAI), a multicenter prospective cohort study, to determine the rate of joint space loss and likelihood of knee arthroplasty due to magnetic resonance imaging (MRI)-diagnosed meniscal tears or meniscal extrusion in middle-aged adults with no to mild knee osteoarthritis. Participants (n = 2199; mean age, 60.2 years) with Kellgren-Lawrence osteoarthritis grades 2 (mild) (48.7%) or 0 to 1 (none) (51.3%) underwent knee MRIs at enrollment and were followed radiographically for 8 years and for total knee arthroplasty (TKA) for 9 years. Rate of joint space loss and risk of arthroplasty due to meniscal tears and/or extrusion were determined by multivariate modeling. Prevalence of baseline medial meniscus tears was 21.3% and lateral tears was 12.8%; 26.9% had medial meniscal extrusion (79.6%, <2 mm; 20.4%, +2 mm) and 5.4% had lateral extrusion (75.9%, <2 mm; 24.1%, +2 mm). Median medial joint space loss was 0.06 mm/y and lateral was 0.05 mm/y. Medial tears regardless of extrusion were associated with accelerated medial joint space loss (additional mean, 0.05 mm/y; P = .001). Lateral tears were associated with accelerated lateral joint space loss (additional 0.09 mm/y; P < .001) as was lateral extrusion (additional 0.10 mm/y; P < .001). The yearly incidence of knee arthroplasty was 0.5% without lateral extrusion, 1.5% with extrusion less than 2.0 mm, and 3.7% with extrusion greater than or equal to 2.0 mm. Both medial and lateral tears accelerate joint space loss in middle-aged adults. Lateral meniscal extrusion further accelerates joint space loss and increases risk of progression to TKA within 9 years. K E Y W O R D S knee osteoarthritis, meniscal extrusion, meniscus tears, total knee arthroplasty 1 | INTRODUCTION An intact knee meniscus plays a critical role and serves to preserve normal joint surface contact forces by providing load dispersion and withstanding shear and compression forces. 1,2 Meniscal tears are one of the most commonly encountered orthopedic injuries, with an incidence of 24 per 100 000 person-years. 3 There has been increasing evidence that damage to the meniscus and removal of meniscal tissue via meniscectomy can result in early-onset osteoarthritis (OA) later in life. 4,5 Meniscus loss can result in increased joint laxity,

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A Prospective Outcomes Study of Meniscal Allograft Transplantation

Abstract: The results confirm that meniscal transplantation significantly reduces pain, decreases activity-related effusions, and improves function in patients with prior meniscectomy; however, the long-term chondroprotective effects remain unknown.

Cited by 84 publications

References 33 publications

Medial Meniscal Allograft Transplantation: The Bone Plug Technique

Medial Meniscal Allograft Transplantation: The Bone Plug Technique

Intraarticular injection of synovial stem cells promotes meniscal regeneration in a rabbit massive meniscal defect model

Meniscus tears accelerate joint space loss and lateral meniscal extrusion increases risk of knee arthroplasty in middle‐aged adults

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