Arthroscopic meniscal allograft transplantation with two tibia tunnels without bone plugs: evaluation of healing on MR arthrography and functional outcomes

Roumazeille, Thibaut; Klouche, Shahnaz; Rousselin, B.; Bongiorno, Vito; Graveleau, Nicolas; Billot, N.; Hardy, Philippe

doi:10.1007/s00167-013-2476-1

Cited by 24 publications

(15 citation statements)

References 51 publications

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“…As shown in Figure 6 , there is a mean increase of 23.1 points at final follow-up. As the mean follow-up is six years for all these patients, the conclusion is that at a mid-term outcome patients experience a significant increase in their functionality after MAT [ 4 , 5 , 40 , 48 , 53 , 54 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

“…These findings make it difficult to draw a definite conclusion, thus a more homogeneous approach of reporting survival data is needed. A total of 167 out of 1665 patients converted to a prosthesis at a mean time of 10.5 years [ 3 – 8 , 12 , 13 , 16 – 19 , 23 – 27 , 30 , 33 , 39 , 53 , 62 , 65 ]. The complication rate of MAT is comparable to standard meniscal repair surgery.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 459 knees had moderate to severe osteoarthritis, so they did not meet the indication. Only a limited number of authors found no significant difference in survival rate, thus the osteoarthritis grade should still be considered pre-operatively [ 7 , 9 – 19 , 21 – 23 , 27 – 30 , 34 – 37 , 39 , 42 – 49 , 53 – 59 , 67 , 69 ].…”

Section: Resultsmentioning

confidence: 99%

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Meniscal allograft transplantation: a meta-analysis

Bruycker

Verdonk

2017

SICOT-J

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Purpose: This meta-analysis evaluates the mid- to long-term survival outcome of MAT (meniscal allograft transplantation). Potential prognosticators, with particular focus on chondral status and age of the patient at the time of transplantation, were also analysed. Study design: Meta-analysis. Methods: An online database search was performed using following search string: “meniscal allograft transplantation” and “outcome”. A total of 65 articles were analysed for a total of 3157 performed MAT with a mean follow-up of 5.4 years. Subjective and clinical data was analysed. Results: The subjective and objective results of 2977 patients (3157 allografts) were analysed; 70% were male, 30% were female. Thirty-eight percent received an isolated MAT. All other patients underwent at least one concomitant procedure. Lysholm, Knee injury and Osteoarthritis Outcome (KOOS), International Knee Documentation Committee (IKDC) and Visual Analogue Scale (VAS) scores were analysed. All scores showed a good patient satisfaction at long-term follow-up. The mean overall survival rate was 80.9%. Complication rates were comparable to standard meniscal repair surgery. There was a degenerative evolution in osteoarthritis with at least one grade in 1760 radiographically analysed patients. Concomitant procedures seem to have no effect on the outcome. Age at transplantation is a negative prognosticator. The body mass index (BMI) of the patient shows a slightly negative correlation with the outcome of MAT. Conclusions: MAT is a viable solution for the younger patient with chronic pain in the meniscectomised knee joint. The complications are not severe and comparable to meniscal repair. The overall failure rate at final follow-up is acceptable and the allograft heals well in most cases, but MAT cannot be seen as a definitive solution for post-meniscectomy pain. The correct approach to the chronic painful total meniscectomised knee joint thus requires consideration of all pathologies including alignment, stability, meniscal abnormality and cartilage degeneration. It requires possibly combined but appropriate action in that order.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Meniscal allograft transplantation: a meta-analysis

Bruycker

Verdonk

2017

SICOT-J

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“…Moreover, the underlying molecular mechanism and gene expression changes might be other significant causes [2]. Previous studies on the meniscus have primarily focused on the biomechanics [3][4][5][6][7], and only a few investigations have studied its molecular aspects [8,9].…”

Section: Introductionmentioning

confidence: 99%

Substantive molecular and histological changes within the meniscus with tears

Long

Xie

Zhang

et al. 2019

BMC Musculoskelet Disord

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Background: The meniscus plays a vital role in the normal biomechanics of the knee. However, it is not well studied at the molecular level. The purpose of this study was to determine whether molecular and pathological changes in the meniscal tissue vary depending on the presence or absence of meniscal and/or anterior cruciate ligament tear (ACL). Methods: Six normal menisci (group A), seven simple torn menisci (group B) and seven torn menisci with concomitant anterior cruciate ligament tears (group C) were collected. We observed the pathological changes in the menisci and used real-time polymerase chain reaction along with immunohistochemistry and in situ hybridisation to examine the levels of ACAN, ADAMTS5, COL10A1, CEBPβ, MMP13 and miR-381-3p, miR-455-3p, miR-193b-3p, miR-92a-3p, respectively. Patients were scored preoperatively and postoperatively using the Lysholm Knee Scoring Scale and International Knee Documentation Committee Subjective Knee Evaluation Form. Results: Compared with group A, the expression levels of ADAMTS5, COL10A1, CEBPβ, and MMP13 and all the miRNAs were increased while ACAN was down-regulated in groups B and C. Additionally, the gene expression and miRNA levels were higher in group C than that in group B, except for ACAN, which was lower. Several fibrochondrocytes strongly expressed ADAMTS5, CEBPβ, and MMP13 in groups B and C and had high levels of miR-381-3p and miR-455-3p than that in group A. Postoperative Lysholm and IKDC scores were higher in group B than in group C. Conclusions:Our findings suggest that the meniscus tended to degenerate after it was injured, especially when combined with a torn ACL. The miRNAs investigated in this study might also contribute to meniscus degeneration. Patients with a combined injury patterns might have relatively worse joint function.

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“…Failure rates varied from 0% to 33.3% in the studies evaluated17,21). Recent evaluation of MAT has indicated limited functional outcomes in patients returning to high-level physical activities.…”

Section: Discussionmentioning

confidence: 99%

Meniscal Transplants and Scaffolds: A Systematic Review of the Literature

Dangelmajer

Familiari

et al. 2017

Knee Surg Relat Res

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The reported incidence of meniscal tears is approximately 61 per 100,000. In instances where preservation of the native meniscus is no longer a feasible option, meniscal allograft transplantation (MAT) and implants or scaffolds may be considered. The goal of this review was to compare the success and failure rates of two techniques, MAT and meniscal scaffolds, and make an inference which treatment is more preferable at the present time and future. Studies that met inclusion criteria were assessed for technique used, type of transplant used, number of procedures included in the study, mean age of patients, mean follow-up time, number of failures, failure rate, and reported reoperation rate. Fifteen studies for the MAT group and 7 studies for the meniscal scaffold group were identified. In this selection of studies, the average failure rate in the MAT group was 18.7% and average reoperation rate was 31.3%. The average failure rate in the meniscal scaffold group was 5.6%, and average reoperation rate was 6.9%. It appears that although MAT is associated with high reoperation and failure rates, the limited number of studies on both MAT and scaffolds and mainly short-term results of scaffold studies make it difficult to make an objective comparison.

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Arthroscopic meniscal allograft transplantation with two tibia tunnels without bone plugs: evaluation of healing on MR arthrography and functional outcomes

Abstract: Retrospective study, Level IV.

Cited by 24 publications

References 51 publications

Meniscal allograft transplantation: a meta-analysis

Meniscal allograft transplantation: a meta-analysis

Substantive molecular and histological changes within the meniscus with tears

Meniscal Transplants and Scaffolds: A Systematic Review of the Literature

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