Superior pain relief and quality of life with autografts using semitendinosus or patellar ligament compared to allografts in meniscal reconstruction: A 2‐year prospective comparative study

Abstract

PurposeThis study aims to compare the 2‐year clinical outcomes of meniscal reconstructions using allograft versus autograft tissue, with a focus on patient‐reported outcomes, complication rates and surgical revision rates.MethodsThis prospective comparative cohort study included 60 patients (ages 18–60 years) undergoing meniscal reconstruction. Patients were divided into an allograft group (n = 31) and an autograft group (n = 29; Hamstring tendon = 25 and patellar tendons = 4). Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), University of California, Los Angeles (UCLA) score and EuroQol‐5D (EQ‐5D) score. Surgical revision rates, reoperation rates and complication rates were recorded. Time‐to‐reoperation was analyzed using Kaplan–Meier survival curves and a Cox hazards model was used to identify predictors of time‐to‐reoperation/revision (failure).ResultsAt 2 years, the autograft group had higher KOOS pain scores (89.93 vs. 86.87, p = 0.002) and EQ‐5D scores (0.884 vs. 0.802, p = 0.002) compared to the allograft group. There were no differences in KOOS sports, symptoms, activities of daily living or UCLA scores between the groups. The allograft group had a higher complication (relative risk [RR] = 2.34, 95% confidence interval [CI]: 0.49–11.13, p = 0.266), reoperation (RR = 1.87, 95% CI: 0.51–6.80, p = 0.329) and revision surgery rates (RR = 2.81, 95% CI: 0.31–25.48, p = 0.334), although not statistically significant. Cox modelling identified autograft as a significant predictor of reduced reoperation risk (hazards ratio = 0.057, 95% CI: 0.004–0.036, p = 0.036), with higher preoperative KOOS pain and sports scores also associated with reduced reoperation risk.ConclusionThese preliminary results show that meniscal reconstruction using autograft tissue is associated with better clinical outcomes in terms of pain relief and quality of life, as well as lower reoperation and complication rates, compared to allograft tissue. However, these observations need to be validated by well‐powered research.Level of EvidenceLevel III prospective.