Meniscal Allograft Transplantation After Anterior Cruciate Ligament Reconstruction Can Improve Knee Stability: A Comparison of Medial and Lateral Procedures

Yoon, Kyoung Ho; Park, Soo Yeon; Yeak, Raymond Dieu Kiat; Kim, Jung-Suk; Park, Jae Young

doi:10.1177/0363546520938771

Cited by 16 publications

(13 citation statements)

References 19 publications

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“…15,33 Moreover, no study has analyzed only the outcomes of medial MAT, although factors affecting the outcomes of medial and lateral MAT might be different. 1,12,35 The purpose of this study was to determine the survival rate of the graft after medial MAT and investigate patient factors that affect its survival. We hypothesized that certain patient factors would influence the survival rate of the graft after medial MAT.…”

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confidence: 99%

“…21,27 The medial meniscus is a kind of medial pivot between the convex surface of the femur and the concave surface of the tibia and plays an important role as a joint stabilizer, especially against anterior translation of the tibia during a Lachman test in the anterior cruciate ligament (ACL)–deficient knee. 17,20,22,28,35 Therefore, the surgical methods and indications for medial and lateral MAT are different, and it is important to analyze the MAT results of the medial and lateral compartments separately. Despite these differences, previous studies analyzing factors affecting the results of MAT, such as cartilage, alignment, and instability, have not differentiated between medial and lateral MAT.…”

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Effect of ICRS Lesion Grade on Graft Survival After Medial Meniscal Allograft Transplantation: MRI-Based Objective Evaluation

et al. 2022

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Background: Data are lacking regarding the survival rate after medial meniscal allograft transplantation (MAT) alone. Furthermore, little information is available about prognostic factors for graft survival that affect the outcomes of medial MAT. Purpose: To investigate the prognostic factors and survival rate of allograft after medial MAT. Study Design: Case-control study; Level of evidence, 3. Methods: The records of 78 consecutive patients who underwent primary medial MAT between 1996 and 2018 were reviewed. Kaplan-Meier survival analysis was performed to analyze the anatomic and clinical survival rates. Anatomic failure was defined as a tear covering >50% of the allograft or unstable peripheral rim. Clinical failure was considered Lysholm score <65 or need for additional surgery such as meniscal repair, revision MAT, realignment osteotomy, and meniscectomy for >50% of the allograft. Patient factors affecting anatomic and clinical failure were analyzed. Results: The mean follow-up period was 6.9 ± 5.3 years (range, 2-21 years). Anatomic failure was noted in 19 patients (24.4%), and none of these patients had a persistent poor Lysholm score of <65; of these, 2 patients who underwent meniscal repair also had clinical failure. Clinical failure was noted in 7 patients (9.0%); 4 patients had Lysholm score <65, 2 patients underwent meniscal repair, and 1 patient underwent realignment osteotomy. The estimated 10-year anatomic and clinical survival rates were 73.89% and 87.90%, respectively. Anatomic survival was significantly associated with only high-grade International Cartilage Regeneration & Joint Preservation (ICRS) lesion (ICRS grade 3 or 4) (hazard ratio, 3.171; 95% CI, 1.124-8.944; P = .029). However, the clinical survival rate was not significantly associated with any factors. Patients with low-grade ICRS lesion (ICRS grade 0, 1, or 2) showed a higher estimated 10-year anatomic survival rate compared with patients with high-grade ICRS lesions (87.6% vs 63.3%, respectively; P = .022). Conclusion: Low-grade ICRS lesion was associated with higher anatomic survival rate after medial MAT. In patients with high-grade ICRS lesions, the clinical outcome might be good; however, the status of an allograft might be poor. The surgeon should be aware of this and explain to the patient that close observation is necessary.

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Effect of ICRS Lesion Grade on Graft Survival After Medial Meniscal Allograft Transplantation: MRI-Based Objective Evaluation

et al. 2022

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“… 15 Zaffagnini et al 31 reported that MMAT with concomitant primary or revision ACLR yielded better results than LMAT in knees with ACL injury or failure of ACLR after meniscectomy. MMAT improved rotational stability as well as anterior posterior stability in a retrospective study by Yoon et al 29 investigating 16 cases of MMAT and 15 cases of LMAT with previous ACLR. In a meta-analysis of 24 studies that compared isolated MAT and combined MAT no significant difference was found in Lysholm, Tegner activity, IKDC subjective, or VAS scores.…”

Section: Discussionmentioning

confidence: 99%

“…30 Degenerative lesions mainly occur on the medial side, and the medial meniscus acts as a secondary stabilizer for anterior translation together with the anterior cruciate ligament (ACL). 29 The lateral meniscus covers 84% of the lateral tibial plateau and transmits approximately 70% of the load. 30 Compared with the medial meniscus, the lateral meniscus is more mobile, and acute traumatic lesions predominantly occur there.…”

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Assessment of Anatomic Restoration and Clinical Outcomes Between Medial and Lateral Meniscal Allograft Transplantation

Jeong

Kim

Nam

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Proper anatomic restoration is an important consideration for meniscal allograft transplantation (MAT), even with the different anatomica characteristics between the medial meniscus and lateral meniscus. Purpose/Hypothesis: The purpose of this study was to assess the accuracy of anatomic restoration in medial and lateral MAT (MMAT and LMAT) procedures and to compare their outcomes. We hypothesized that (1) the anatomic differences between the medial and lateral menisci will mean a less accurate anatomic restoration for MMAT and (2) clinical outcomes after MMAT will be inferior compared with LMAT. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively evaluated 20 patients who underwent MMAT using the bone plug technique and 21 patients who underwent LMAT using the keyhole technique at a single institution from July 2014 to June 2019. Demographic data, previous surgeries, and concomitant procedures were recorded, as were lower limb alignment and osteoarthritis grade on radiographs. Using preoperative and follow-up magnetic resonance imaging, the meniscal position, rotation, extrusion, and intrameniscal signal intensity were evaluated. Clinical outcomes were evaluated using the International Knee Documentation Committee and Lysholm scores. Results: The mean follow-up was 41.15 ± 18.86 and 45.43 ± 21.32 months for the MMAT and LMAT patients, respectively. Concomitant procedures were performed in 90% of MMATs and 15% of LMATs. There was no significant difference between the native and postoperative root positions after LMAT; however, for MMAT, the position of the anterior root was located significantly posteriorly ( P = .002) and medially ( P = .007) compared with preoperatively. In addition, the allograft medial meniscus was restored in a more internally rotated position ( P = .029). MMATs also exhibited significantly increased meniscal extrusion compared with LMATs (posterior horn, P < .001; midbody, P = .027; anterior horn, P = .006). However, there was no significant difference between the 2 groups at final follow-up in intrameniscal signal intensity or clinical scores. Conclusion: LMAT showed higher accuracy than MMAT in restoring meniscal position and rotation, and there was less meniscal extrusion. However, clinical scores improved after both LMAT and MMAT compared with preoperative values, and midterm clinical outcomes were similar. The small anatomical errors seen in the MMAT technique were not clinically relevant at midterm follow-up.

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“…An imbalance of muscle force between the medial oblique and lateral femoris muscles can lead to and can result in lateral patella tracking and pain during knee flexion-extension. 5 , 6 Transcutaneous electrical muscle stimulation (TEMS) has been used to rehabilitate the lower extremity function after ACL repair/reconstruction. 7 Medium frequency electrical stimulation of the medial femoral muscle should be useful to improve knee function recovery after ACL reconstruction, but no studies have evaluated this approach.…”

Section: Introductionmentioning

confidence: 99%

Intermediate frequency electrotherapy stimulation to the medial femoris muscle for functional recovery of knee joint after anterior cruciate ligament reconstruction

Song¹,

Ma²,

Zhang³

et al. 2022

Pak J Med Sci

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Objectives: To compare the effect of medial femoral muscle stimulation with medium frequency electrotherapy and conventional rehabilitation therapy on knee function recovery after anterior cruciate ligament (ACL) reconstruction. Methods: Medical records of 50 patients with ACL reconstruction, treated in our hospital between July 2019 and December 2020, were retrospectively analyzed. Patients were divided into control group and study group (n=25, 18 males and 7 females in each group), based on the rehabilitation method used. The control group included patients that received conventional rehabilitation therapy, active quadriceps femoris exercise, traction, and acupuncture. The study group included patients that received medium frequency electrotherapy to stimulate the medial femoris muscle in addition to conventional rehabilitation therapy. The limb circumference recorded before and after the treatment was compared between the two group. The Lysholm scores of the two groups were compared to assess knee function, knee range of motion, and knee motor comfort assessed by visual analogue scale (VAS). Results: We found similar thigh circumferences, Lysholm scores, knee motion ranges and VAS scores between the patients in both groups before the treatment (P > 0.05). After the treatment, the thigh circumferences and motion ranges were larger, the Lysholm scores higher, and the VAS scores lower in patients of the study group than those in patients of the control group (all Ps < 0.05). Conclusion: Intermediate frequency electrotherapy to stimulate the medial femoris muscle can improve knee function and motion range and reduce the patient’s pain after ACL reconstruction. doi: https://doi.org/10.12669/pjms.38.3.5298 How to cite this:Song D, Ma Y, Zhang L, Ma Q. Intermediate frequency electrotherapy stimulation to the medial femoris muscle for functional recovery of knee joint after anterior cruciate ligament reconstruction. Pak J Med Sci. 2022;38(3):652-656. doi: https://doi.org/10.12669/pjms.38.3.5298 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Meniscal Allograft Transplantation After Anterior Cruciate Ligament Reconstruction Can Improve Knee Stability: A Comparison of Medial and Lateral Procedures

Cited by 16 publications

References 19 publications

Effect of ICRS Lesion Grade on Graft Survival After Medial Meniscal Allograft Transplantation: MRI-Based Objective Evaluation

Effect of ICRS Lesion Grade on Graft Survival After Medial Meniscal Allograft Transplantation: MRI-Based Objective Evaluation

Assessment of Anatomic Restoration and Clinical Outcomes Between Medial and Lateral Meniscal Allograft Transplantation

Intermediate frequency electrotherapy stimulation to the medial femoris muscle for functional recovery of knee joint after anterior cruciate ligament reconstruction

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