Abstract
Background
The meniscal deficient knee often exists in the setting of associated pathology including instability, malalignment and chondral injury. Meniscal allograft transplantation (MAT) is established to be a reliable option in restoring function and treating symptoms. The aim of this study was to establish the role of MAT as part of a staged approach to treatment of the previously menisectomised knee.
Methods
This prospective study included all patients that underwent arthroscopic MAT at our institution between 2010 to 2017. Fresh frozen allograft was utilised using a soft tissue fixation technique. Further data was collected for index surgical procedures before and after MAT. Data for pre and post-operative Knee Injury and osteoarthritis outcome scores (KOOS), Tegner scores, graft survival, reoperation rates, patient satisfaction and MRI extrusion measurements were collected and details of any further surgical intervention and / or complications also documented.
Results
Twenty seven MAT procedures were performed in 26 patients. Sixteen patients underwent lateral MAT and 11 patients medial. Ten patients underwent ACL reconstruction, three ACI and two, osteotomy in the pre-MAT phase. A further seven patients underwent ACI within the post-operative phase. The post-operative mean KOOS scores improved significantly in all subscales as did Tegner scores. Graft survival was 100%, satisfaction rate 92%, and mean meniscal extrusion 3.04mm. Post operatively, three patients required meniscal repair and a single patient partial menisectomy of graft. Two patients underwent arthroscopic arthrolysis following MAT.
Conclusions
This series highlights the multifactorial profile of the meniscal deficient knee and the role of MAT as a safe and reliable technique in the staged and comprehensive biologic treatment available to minimise symptoms and maximise outcomes.
