International Meniscus Reconstruction Experts Forum (IMREF) 2015 Consensus Statement on the Practice of Meniscal Allograft Transplantation

Abstract

Meniscal allograft transplantation (MAT) has become relatively commonplace in specialized sport medicine practice for the treatment of patients with a symptomatic knee after the loss of a functional meniscus. The technique has evolved since the 1980s, and long-term results continue to improve. However, there still remains significant variation in how MAT is performed, and as such, there remains opportunity for outcome and graft survivorship to be optimized. The purpose of this article was to develop a consensus statement on the practice of MAT from key opinion leaders who are members of the International Meniscus Reconstruction Experts Forum so that a more standardized approach to the indications, surgical technique, and postoperative care could be outlined with the goal of ultimately improving patient outcomes.

Editorial Commentary: Meniscal Allografts Can Be for Grandparents Too

“…As surgeons have gained experience, the indications have significantly been refined and the procedure has become successful. 2,3 The symptoms should be in the involved compartment rather than generalized.…”

“…Thus, while the results are "inferior" for the old age group, as their article's title states, it is an effective treatment for both age categories. 2 There is still much to be learned about meniscal allografts in efforts to improve patient outcomes. Age parameter is one area that has not really changed over the years.…”

Meniscal transplantation: state of the art

“…However, avoiding these activities for the first 6–12 months may be considered reasonable based on the biology of meniscal healing and the available literature 33. Strenuous activity cannot be recommended, however, because repetitive high impacts can lead to producing unpredictable results in the allograft indemnity 33 74.…”

“…Advanced cartilage injury: The outcomes after MAT may be compromised by the presence of OA and indication in this scenario should be taken with caution 33. Although some studies report promising results with a mean graft survivorship of 12 years in patient with advanced chondral injuries,16 larger series and a number of meta-analyses have all demonstrated that poorer outcomes are expected in the face of OA 85.…”

“…A functional medial meniscus in these patients may increase stability 33. It is the authors’ conviction that an ACL graft is significantly protected by the meniscus allografts as much as the meniscus is protected by an ACL graft.…”