Transplantation of Viable Meniscal Allograft

Verdonk, Peter; Demurie, Alex; Almqvist, Karl; Veys, Eric; Verbruggen, Gust; Verdonk, René

doi:10.2106/jbjs.c.01344

Cited by 284 publications

(84 citation statements)

References 37 publications

(65 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…14,31,55 Although results are mixed, long-term studies have shown enough benefits to justify the procedure in appropriately indicated patients. 68,69,72,77 To date, 2 survival-analysis investigations of meniscus transplantation have been published. van Arkel and de Boer 68 followed 63 consecutive cryopreserved meniscal transplants 4 to 126 months after surgery.…”

Section: Meniscus Transplantationmentioning

confidence: 99%

“…The cumulative 10-year survival rates of lateral, medial, and combined transplants in the same knee were 76%, 50%, and 67%, respectively. Verdonk et al 72 followed 100 fresh meniscus transplants a mean of 7.2 years postoperatively. End points for failure were moderate or severe pain, occasional or persistent pain, or poor knee function.…”

Section: Meniscus Transplantationmentioning

confidence: 99%

See 1 more Smart Citation

Meniscus Repair and Transplantation: A Comprehensive Update

Noyes¹,

Heckmann²,

Barber-Westin³

2012

Journal of Orthopaedic & Sports Physical Therapy

101

View full text Add to dashboard Cite

Synopsis Preservation of meniscal tissue is paramount for long-term joint function, especially in younger patients who are athletically active. Many studies have reported encouraging results following repair of meniscus tears for both simple longitudinal tears located in the periphery and complex multiplanar tears that extend into the central third avascular region. This operation is usually indicated in active patients who have tibiofemoral joint line pain and are less than 50 years of age. However, not all meniscus tears are repairable, especially if considerable damage has occurred. In select patients, meniscus transplantation may restore partial load-bearing meniscus function, decrease symptoms, and provide chondroprotective effects. The initial postoperative goal after both meniscus repair and transplantation is to prevent excessive weight bearing, as high compressive and shear forces can disrupt healing meniscus repair sites and transplants. Immediate knee motion and muscle strengthening are initiated the day after surgery. Variations are built into the rehabilitation protocol according to the type, location, and size of the meniscus repair, if concomitant procedures are performed, and if articular cartilage damage is present. Meniscus repairs located in the periphery heal rapidly, whereas complex multiplanar repairs tend to heal more slowly and require greater caution. The authors have reported the efficacy of the rehabilitation programs and the results of meniscus repair and transplantation in many studies. J Orthop Sports Phys Ther 2012;42(3):274–290, Epub 4 September 2011. doi:10.2519/jospt.2012.3588

show abstract

Section: Meniscus Transplantationmentioning

confidence: 99%

Section: Meniscus Transplantationmentioning

confidence: 99%

Meniscus Repair and Transplantation: A Comprehensive Update

Noyes¹,

Heckmann²,

Barber-Westin³

2012

Journal of Orthopaedic & Sports Physical Therapy

101

View full text Add to dashboard Cite

show abstract

“…29,30 Meniscus allograft transplantation (MAT) is undertaken primarily to relieve pain; in addition, an underlying intention is to redistribute the joint loads across the involved compartment in the hope of restoring normal contact mechanics in the transplanted meniscal joint. While MAT has demonstrated pain relief and functional improvement in up to 70% of patients, 42 the ability of this surgical procedure to restore normal knee contact mechanics during daily activities has yet to be investigated. 12 …”

mentioning

confidence: 99%

Bone Plug Versus Suture-Only Fixation of Meniscal Grafts

et al. 2014

View full text Add to dashboard Cite

Background Meniscus allograft transplantation (MAT) is primarily undertaken to relieve the symptoms associated with meniscal deficiencies. However, its ability to restore normal knee joint contact mechanics under physiological loads is still unclear. Purpose To quantify the dynamic contact mechanics associated with 2 commonly used fixation techniques in MAT of the medial compartment: transosseous suture fixation via bone plugs and suture-only fixation at the horns. Study Design Controlled laboratory study. Methods Physiological loads to mimic gait were applied across 7 human cadaveric knees on a simulator. A sensor placed on the medial tibial plateau recorded dynamic contact stresses under the following conditions: (1) intact meniscus, (2) MAT using transosseous suture fixation via bone plugs at the anterior and posterior horns, (3) MAT using suture-only fixation, and (4) total medial meniscectomy. A “remove-replace” procedure was performed to place the same autograft for both MAT conditions to minimize the variability in graft size, geometry, and material property and to isolate the effects of the fixation technique. Contact stress, contact area, and weighted center of contact stress (WCoCS) were quantified on the medial plateau throughout the stance phase. Results Knee joint contact mechanics were sensitive to the meniscal condition primarily during the first half of the gait cycle. After meniscectomy, the mean peak contact stress increased from 4.2 ± 1.2 MPa to 6.2 ± 1.0 MPa (P = .04), and the mean contact area decreased from 546 ± 132 mm2 to 192 ± 122 mm2 (P = .01) compared with the intact meniscus during early stance (14% of the gait cycle). After MAT, the mean contact stress significantly decreased with bone plug fixation (5.0 ± 0.7 MPa) but not with suture-only fixation (5.9 ± 0.7 MPa). Both fixation techniques partially restored the contact area, but bone plug fixation restored it closer to the intact condition. The location of WCoCS in the central cartilage region (not covered by the meniscus) shifted peripherally throughout the stance phase. Bone plug fixation exhibited correction to this peripheral offset, but suture-only fixation did not. Conclusion Under dynamic loading, transosseous fixation at the meniscal horns provides superior load distribution at the involved knee compartment after meniscal transplantation compared with suture-only fixation. Particular attention should be directed to the ability of medial MAT to function during the early stance phase. Clinical Relevance Transosseous fixation via bone plugs provides superior load distribution of a transplanted meniscal allograft compared with suture fixation alone at time zero.

show abstract

“…Lateral femoral epicondylar osteotomy is a safe method for opening the lateral compartment without injury to the soft tissue structures because the bony wafer, including the lateral collateral ligament and popliteus tendon, is separated [4]. We have commonly used lateral femoral epicondylar osteotomy together with the balancing technique of total knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

“…Since the introduction of lateral femoral epicondylar osteotomy for the effective exposure of posterolateral intra-articular structures, this technique has been used for meniscal transplantation, total knee arthroplasty, and the treatment of posterolateral articular disorders of the femur and tibia [3][4][5][6]. Lateral femoral epicondylar osteotomy is a safe method for opening the lateral compartment without injuring the lateral collateral ligament, popliteus tendon, and neurovascular structures [6].…”

Section: Introductionmentioning

confidence: 99%