Abstract
Introduction: Meniscus allograft transplantation can restore function in patients with arthritis secondary to prior total meniscectomy. The transplantation of a biological load-bearing structure in young patients has given reliable long-term results, when used in well-selected cases.
Method: One hundred and forty-eight meniscus allografts transplanted in l40 patients between 1988 and 2000 were reviewed. The indication for surgery included disabling knee pain, refractory to conservative treatment, objective symptoms of compartmental crepitus, pain on valgus/varus stress and osteoarthritis documented on arthroscopy following prior total meniscectomy. Knee mal-alignment and instability were also documented. Patients with varus alignment and medial OA, as well as valgus alignment with lateral OA, underwent re-alignment to unload the compartment for allograft transplantation. Patients with anterior cruciate deficiency, underwent ACL reconstruction at the time of allograft transplantation.
Results: At a mean follow-up of six years (range two to 14). One hundred and twenty-five received a good to excellent result. Forty-six patients received an isolated meniscus allograft, with 41 receiving good to excellent results. Eleven received a medial or lateral meniscus allograft with an ACL reconstruction and nine obtained good to excellent results. Seventy-five knees received a meniscal allograft in combination with either a valgus high tibial osteotomy, varus high tibial osteotomy or varus distal femoral osteotomy to correct for pre-operative deformity with l26 attaining good to excellent results. The remaining 22 knees underwent valgus high tibial osteotomy, meniscal allograft and ACL repair with 19 receiving good to excellent results.
Outcome was assessed subjectively and functionally using a modified Lysholm score and objectively by clinical examination of stress pain and joint crepitus. The Tegner activity scale comparing pre- and post-operative function was applied. Second-look arthroscopy was performed on the first l0 transplanted meniscii to assess healing and integrity of the transplantation graft.
The most frequent complication was a traumatic posterior horn tear in l3 knees.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
At least one of the authors is receiving or has received material benefits or support from a commercial source.
