Long-Term Survival Analysis and Outcomes of Meniscal Allograft Transplantation With Minimum 10-Year Follow-Up: A Systematic Review

Novaretti, João Victor; Patel, Neel K.; Lian, Jayson; Vaswani, Ravi; de, Darren; Getgood, Alan; Musahl, Volker

doi:10.1016/j.arthro.2018.08.031

Cited by 82 publications

(90 citation statements)

References 46 publications

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“…As the authors noted, only 11 of 3,826 studies were accepted for review. 1 However, as noted by one of the reviewers of this article, "We really need better primary studies than another mash-up of low-quality studies." In addition, is there a perceived over-reach in the conclusions that should be accepted with caution?…”

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confidence: 98%

“…I was excited to read and review the article "Long-Term Survival Analysis and Outcomes of Meniscal Allograft Transplantation With Minimum 10-Year Follow-Up: A Systematic Review" by Novaretti, Patel, Lian, Vaswani, de Sa, Getgood, and Musahl. 1 This article represents a large systematic review of meniscal allograft transplantations (MATs) with a minimum of 10 years' follow-up.…”

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confidence: 99%

“…This gives validity and significance to analysis and conclusions. This technique was used by Novaretti et al, 1 who have carefully pooled the data. They were able to find 658 patients with 688 meniscal allografts who met the inclusion criteria for the analysis.…”

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confidence: 99%

“…Novaretti et al 1 concluded that the long-term survivorship rate was 73.5% at 10 years and 60.3% at 15 years. The grafts were functional, and the results were fair compared with preoperative scores.…”

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confidence: 99%

“…There are many aspects of this article that show the excellent approach of this meta-analysis. 1 The articles chosen were screened through an exacting process. Data extraction was performed with specific critical factors analyzed.…”

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confidence: 99%

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Editorial Commentary: Meniscal Allograft Success—How Do We Get There?

Siegel¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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confidence: 99%

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Editorial Commentary: Meniscal Allograft Success—How Do We Get There?

Siegel¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Addressing meniscal deficiency part 1: An umbrella review of systematic reviews and meta‐analyses on meniscal allograft transplantation

Wu,

Kiwinda,

Therien

et al. 2024

J. exp. orthop.

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PurposeMeniscal injuries are common in the young and active population. There is increasing utilization of surgical interventions like meniscal allograft transplantation (MAT) to restore the protective function of menisci following injury leading to meniscal deficiency. Extensive research and publications exist on the management of meniscal injury and the sequalae of meniscal deficiency. However, a comprehensive synthesis of the existing evidence through an umbrella review is lacking. This study aims to fill this gap by providing a current examination of the literature on MAT.MethodsA comprehensive search was conducted in the MEDLINE, Embase and Scopus databases to identify relevant systematic reviews and meta‐analyses. Studies were screened based on predefined inclusion and exclusion criteria. The quality of the included studies was assessed using the AMSTAR‐2 tool.ResultsA total of 41 studies were included in the review, with most published within the last decade. The majority of studies (56.1%) received a ‘Critically Low’ confidence rating, 26.8% were rated as ‘Low’, and only 14.6% were rated as ‘High’ confidence. From the included studies, 51.2% reported on PROMs, with the Lysholm score being the most common. Transplant failure and reoperation rate were reported in 34.1% and 19.5% of studies respectively. Studies on MAT reported favourable short‐term outcomes in terms of patient‐reported outcome measures (PROMs) but were limited by the lack of randomized control trials and consistent comparison groups.ConclusionsThis umbrella review highlights an increase in interest in MAT but underscores the need for higher‐quality reviews with standardized reporting and rigorous methodologies. Future research should focus on long‐term outcomes, optimal surgical techniques, patient selection criteria and risk factors for transplant failure. There is also a need for more studies focusing on MAT in pediatric populations. Overall, this review provides a comprehensive assessment of the current state of research in MAT and identifies areas for improvement in future studies.Level of EvidenceLevel IV.

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Significant improvements in clinical outcome measures and patient satisfaction after combined all‐arthroscopic meniscal allograft transplantation and autologous chondrocyte implantation: A single‐centre longitudinal study

Pawelczyk,

Fanourgiakis,

Feil

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe optimal treatment approach for the complex pathology of meniscal insufficiency and coexisting full‐thickness cartilage defects remains unclear. The purpose of this study was to evaluate the viability, safety, and efficacy of this combined surgical approach at medium‐term follow‐up.MethodsThis is a single‐centre longitudinal study with blinded outcome assessment. All consecutive patients treated with combined all‐arthroscopic meniscal allograft transplantation (MAT) with bone bridge fixation and ACI using chondrospheres at our institution between 2001 and 2021 were eligible for inclusion. Twenty patients with an average follow‐up of 72.6 ± 34.4 months were included in the statistical analysis. Clinical outcomes were assessed pre‐ and postoperatively using the IKDC Subjective Knee Form, Lysholm Score, Tegner Activity Scale, KOOS, and Visual Analog Scale (VAS) for patient satisfaction. Failure and reoperation rates were assessed, and cartilage regeneration tissue was evaluated on postoperative MRI.ResultsIKDC scores significantly improved from 52.1 ± 16.9 to 68.5 ± 16.3 (p = 0.003). Lysholm scores improved from 61.5 ± 21.7 to 78.5 ± 12.9 (p = 0.004). Tegner scores improved from 3.5 (1–4) to 4.0 (2–6) (p = 0.014). KOOS scores improved significantly across all subcategories, except ‘symptoms’, where improvements did not reach statistical significance. VAS for overall patient satisfaction showed improvements but did not reach statistical significance. The combined procedure was successful in 17 patients (85%). Eight patients had to undergo reoperation (40%), comprising mostly small, arthroscopic procedures. Seven reoperations were directly attributable to meniscal allograft transplantation (46.7%). Postoperative Magnetic Resonance Observation of Cartilage Repair Tissue scores were 68.9 ± 16.8 (n = 14).ConclusionCombined arthroscopic MAT and autologous chondrocyte implantation (ACI) is a viable, safe, and effective treatment approach for younger patients with meniscal insufficiency and coexisting full‐thickness cartilage damage, where alternative treatment options are limited. The combined surgical procedure achieved significant improvements in clinical outcome measures and patient satisfaction with acceptable failure and high arthroscopic reoperation rates. MAT is the limiting part of this combined procedure, with most failures and reoperations being attributable to MAT, as opposed to ACI.Level of Evidence: Level III.

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Long-Term Survival Analysis and Outcomes of Meniscal Allograft Transplantation With Minimum 10-Year Follow-Up: A Systematic Review

Cited by 82 publications

References 46 publications

Editorial Commentary: Meniscal Allograft Success—How Do We Get There?

Editorial Commentary: Meniscal Allograft Success—How Do We Get There?

Addressing meniscal deficiency part 1: An umbrella review of systematic reviews and meta‐analyses on meniscal allograft transplantation

Significant improvements in clinical outcome measures and patient satisfaction after combined all‐arthroscopic meniscal allograft transplantation and autologous chondrocyte implantation: A single‐centre longitudinal study

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