Effect of Sagittal Allograft Position on Coronal Extrusion in Lateral Meniscus Allograft Transplantation

Lee, Dae-Hee; Kim, Jong-Min; Jeon, Ju-Hyun; Cha, Eun‐Jong; Bin, Seong‐Il

doi:10.1016/j.arthro.2014.08.021

Cited by 22 publications

(14 citation statements)

References 25 publications

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“…In this procedure, the positions of the anterior and posterior horns were determined separately. While the posterior horn position was determined under arthroscopic guidance, the anterior horn position was determined with the naked eye [ 31 ]. Positioning the tunnel for the bone plug at an accurate anatomical horn position is difficult, as soft tissue such as patellar fat pads can obstruct the view of the anterior horn.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Extent of Graft Extrusion following Meniscus Allograft Transplantation

Lee

2018

BioMed Research International

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Background The incidence and extent of graft extrusion after meniscus allograft transplantation (MAT) may differ in patients undergoing medial and lateral meniscus transplantation due to the use of different surgical techniques. This meta-analysis was therefore designed to quantify the extent and incidence of graft extrusion after meniscus allograft transplantation. Methods Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, all studies reporting absolute extrusion, relative percentage of extrusion (RPE), or frequency of major extrusions (>3 mm) on magnetic resonance imaging in patients undergoing medial or lateral MAT were included. Results The pooled mean absolute extrusion following all MATs was 3.15 mm but was significantly greater following medial than lateral MAT (3.26 versus 3.01 mm; p = 0.001). The pooled mean RPE following all MATs was 32.79% and was significantly greater after medial than lateral MAT (32.69% versus 28.81%; p < 0.001). The pooled mean proportion of knees with major (>3 mm) extrusion was 53% (95% CI: 49% to 58%) and was significantly greater after medial than lateral MAT (61% versus 39%; p < 0.001). Conclusion Mean graft extrusion after arthroscopic assisted MAT using bony fixation was 3.2 mm, with major graft extrusion > 3 mm occurring in about 50% of transplanted menisci. Graft extrusion was significantly greater after medial than lateral MAT.

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Section: Discussionmentioning

confidence: 99%

Incidence and Extent of Graft Extrusion following Meniscus Allograft Transplantation

Lee

2018

BioMed Research International

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“…In addition, we also measured many other factors, including the following: the WAH, the WMB, the WPH of each lateral meniscus, the grade of cartilage lesions before surgery, CGE, the CPRE, the ACMD (defined as the distance from the anterior articular margin to the anterior border of the anterior horn of the meniscus), anterior graft extrusion, the APRE, the PCMD (defined as the distance from the posterior articular margin to the posterior border of the meniscus), posterior graft extrusion, and the PPRE 1,8,9,32 .…”

Section: Mri Scan and Image Analysismentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) is commonly used as a noninvasive tool to evaluate graft status after implantation. The sagittal allograft position, morphologic features, shrinkage, extrusion, intrameniscal signal intensities and degeneration of adjacent articular cartilage are often measured 7 – 9 . However, few studies have investigated intrameniscal signal intensities after MAT, and their clinical relevance remains unknown 6 .…”

Section: Introductionmentioning

confidence: 99%

“…In addition, an increasing number of studies on the failure rate of MAT have been conducted [10][11][12][13] . Potential risk factors influencing the failure incidence of MAT, including graft placement, shrinkage, extrusion, and degeneration of adjacent articular cartilage, have been investigated [7][8][9][10][11] . The presence of severe cartilage damage at the time of MAT can cause an increased failure rate 11 .…”

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confidence: 99%

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Correlation analysis of potential factors influencing graft maturity based on MRI after lateral meniscal allograft transplantation

Ren

Zhang

Yu³

et al. 2020

Sci Rep

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The aim of this respective study was to assess the graft signal/noise quotient (SNQ) value and associated factors based on magnetic resonance imaging (MRI) after lateral meniscal allograft transplantation (LMAT). Patients with LMAT were included. The SNQ, width of the anterior horn (WAH), width of the midbody (WMB), width of the posterior horn (WPH) of each lateral meniscus, coronal graft extrusion (CGE), the anterior cartilage meniscus distance (ACMD) and the posterior cartilage meniscus distance (PCMD) were measured using MRI and tested by multivariate stepwise regression analysis. The relative percentage of extrusion (PRE) was calculated. Seventy-one male patients were examined, and 7 patients were lost to follow-up. The SNQ of the meniscus increased from immediately after surgery to 6 months postoperatively, decreased from 6 to 12 months, increased from 12 to 24 months, and increased from 24 to 36 months. The mean SNQ had a significant negative association with the WPH and CGE at 6 months (p < 0.05), the WPH at 1 year (p < 0.05), the PRE of CGE (CPRE) at 2 years (p < 0.05), and the PCMD, CPRE, and PRE of the PCMD (PPRE) at 3 years (p < 0.01) postoperatively. Multivariate stepwise regression analysis showed that the WPH at 6 months, WPH at 1 year, WMD and PCMD at 2 years, and WMD, ACMD and CGE at 3 years were significant independent factors correlated with the mean SNQ of grafts in different periods. Maturation of meniscal grafts fluctuated with time. The maturation process occupied the main role before 1 year postoperatively, but after the maturation process, tearing of the meniscal allograft played the leading role. Changes in an allograft's location had an obvious association with the SNQ. The WPH influenced the graft SNQ value at 6 months and 1 year postoperatively, but after the maturation process, the WMB and graft extrusion played the same roles.

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“…Intended to address several factors related to extrusion, they are the anatomical implantation of the graft,70 the excision of peripheral osteophytes of the tibial plateau71 and the fixation of the meniscus allograft on the tibial surface 72. More recently, the reduction and fixation of the lateral capsule to the tibia has been put forth 73.…”

Section: Allograft Extrusionmentioning

confidence: 99%

Meniscal transplantation: state of the art

et al. 2017

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Meniscal resection is the most common surgical procedure in orthopaedics. When a large meniscal loss becomes clinically relevant, meniscal allograft transplantation (MAT) is a feasible option. However, although this technique has evolved since the ‘80s, there are still several controversial issues related to MAT. Most importantly, its chondroprotective effect is still not completely proven. Its relatively high complication and reoperation rate is another reason for this procedure not yet being universally accepted. Despite its controversial chondroprotective effect, nevertheless, MAT has become a successful treatment for pain localised in a previously meniscectomised knee, in terms of pain relief and knee function. We conducted a careful review of the literature, highlighting the most relevant studies in various aspects of this procedure. Precise indications, how it behaves biomechanically, surgical techniques, return to sport and future perspectives are among the most relevant topics that have been included in this state-of-the-art review.

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Effect of Sagittal Allograft Position on Coronal Extrusion in Lateral Meniscus Allograft Transplantation

Cited by 22 publications

References 25 publications

Incidence and Extent of Graft Extrusion following Meniscus Allograft Transplantation

Incidence and Extent of Graft Extrusion following Meniscus Allograft Transplantation

Correlation analysis of potential factors influencing graft maturity based on MRI after lateral meniscal allograft transplantation

Meniscal transplantation: state of the art

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