Long-term Clinical Outcome of Open Meniscal Allograft Transplantation

Abstract

Background Meniscal allograft transplantation is an accepted treatment for the symptomatic postmeniscectomized knee in younger patients; however, long-term data are scarce on clinical outcome. Hypothesis Cryopreserved meniscal allograft transplantations can, in the long term, be a good alternative for the symptomatic postmeniscectomized knee in younger patients. Study Design Case series; Level of evidence, 4. Methods Sixty-three meniscal allografts (40 lateral and 23 medial) were transplanted with an open procedure in 57 patients. Clinical outcome and failure rate were evaluated at 13.8 ± 2.8 years. Mean age at time of transplantation was 39.4 ± 6.9 years. Results Eight medial and 10 lateral allografts failed (overall failure rate, 29%). Overall Lysholm scores significantly improved from 36 ± 18 preoperatively to 61 ± 20 at long-term follow-up. Scores were not significantly different in the following subgroups: medial allografts, female patients, and left treated knees. All subgroups had poor scores at mean follow-up of 13.8 years, except the male patients group, which had a fair score. Short-term Lysholm scores were 79 ± 19 at 3.1 ± 1.5 years. All subgroups demonstrated a significant difference between short- and long-term Lysholm scores. There were no significant differences in Lysholm scores between posttransplanted survivors and posttransplanted nonsurvivors who received a total knee arthroplasty. For 2 other measures—the Knee injury and Osteoarthritis Outcome Score and the International Knee Documentation Committee scoring system—significant decline was present between men and women only. Conclusion Long-term follow-up results show that meniscal allograft transplantation is a beneficial procedure. Good improvements in clinical function and pain relief have been shown at short-term follow-up in this population. Despite the deterioration in function scores over time, there is still improvement in level of function at long-term follow-up but not at a high level. As such, meniscal allograft transplantation is a good salvage option for the treatment of degenerative arthritis of the symptomatic post-meniscectomized knee. Meniscal allograft transplantation can be used to postpone total knee arthroplasty in younger patients.