J Knee Surg 2013; 26(03): 167-172
DOI: 10.1055/s-0032-1327453
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Meniscal Allograft Shrinkage—MRI Evaluation

Thomas Carter
1   Department of Orthopaedics, The Orthopaedic Clinic Association, Phoenix, Arizona
,
Kostas John Economopoulos
2   Department of Orthopaedics, Banner Good Samaritan, Phoenix, Arizona
› Author Affiliations
Further Information

Publication History

22 October 2011

22 July 2012

Publication Date:
24 October 2012 (online)

Abstract

Purpose Meniscal allograft transplantation (MAT) has been shown to be an effective treatment option for patients with symptomatic meniscal-deficient knees. Several studies have described shrinkage after transplantation of a meniscal allograft; however, no study has specifically quantified the rate or degree of shrinkage that occurs. The purpose of this study was to determine the frequency and amount of meniscal shrinkage that occurs following transplantation.

Methods A prospective study of 25 patients undergoing MAT was performed. Patients underwent MR scans of the meniscal allograft at 1 and 6 months following surgery. Meniscal volume was determined by laser-based noncontacting 3-D coordinate digitizing system (3-DCDS) to acquire the 3-D geometry of the meniscus. The meniscus volume at 1 and 6 months were compared to determine the amount of shrinkage that occurred.

Results The average amount of meniscal shrinkage was 7% (range 0 to 22%). Seventeen (68%) of the grafts showed at least 5% shrinkage and 8 (32%) showed 10% or greater.

Conclusion Meniscal allograft shrinkage is common following transplantation. The average amount of shrinkage is 7%; however, nearly 32% of the grafts had 10% or more shrinkage.

Level of evidence 2.

 
  • References

  • 1 Cox JS, Nye CE, Schaefer WW, Woodstein IJ. The degenerative effects of partial and total resection of the medial meniscus in dogs' knees. Clin Orthop Relat Res 1975; 109 (109) 178-183
  • 2 McGinity JB, Geuss LF, Marvin RA. Partial or total meniscectomy: a comparative analysis. J Bone Joint Surg Am 1977; 59 (6) 763-766
  • 3 Milachowski KA, Weismeier K, Wirth CJ. Homologous meniscus transplantation. Experimental and clinical results. Int Orthop 1989; 13 (1) 1-11
  • 4 Hommen JP, Applegate GR, Del Pizzo W. Meniscus allograft transplantation: ten-year results of cryopreserved allografts. Arthroscopy 2007; 23 (4) 388-393
  • 5 Stollsteimer GT, Shelton WR, Dukes A, Bomboy AL. Meniscal allograft transplantation: a 1- to 5-year follow-up of 22 patients. Arthroscopy 2000; 16 (4) 343-347
  • 6 Wirth CJ, Peters G, Milachowski KA, Weismeier KG, Kohn D. Long-term results of meniscal allograft transplantation. Am J Sports Med 2002; 30 (2) 174-181
  • 7 Carter TR. Meniscal allograft transplantation. Sports Med Arthrosc Rev 1999; 7: 51-62
  • 8 Ryu RK, Dunbar V WH, Morse GG. Meniscal allograft replacement: a 1-year to 6-year experience. Arthroscopy 2002; 18 (9) 989-994
  • 9 Pollard ME, Kang Q, Berg EE. Radiographic sizing for meniscal transplantation. Arthroscopy 1995; 11 (6) 684-687
  • 10 Haut TL, Hull ML, Howell SM. Use of roentgenography and magnetic resonance imaging to predict meniscal geometry determined with a three-dimensional coordinate digitizing system. J Orthop Res 2000; 18 (2) 228-237
  • 11 Sekaran SV, Hull ML, Howell SM. Nonanatomic location of the posterior horn of a medial meniscal autograft implanted in a cadaveric knee adversely affects the pressure distribution on the tibial plateau. Am J Sports Med 2002; 30 (1) 74-82
  • 12 Alhalki MM, Howell SM, Hull ML. How three methods for fixing a medial meniscal autograft affect tibial contact mechanics. Am J Sports Med 1999; 27 (3) 320-328
  • 13 Chen MI, Branch TP, Hutton WC. Is it important to secure the horns during lateral meniscal transplantation? A cadaveric study. Arthroscopy 1996; 12 (2) 174-181
  • 14 Paletta Jr GA, Manning T, Snell E, Parker R, Bergfeld J. The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee. A biomechanical study. Am J Sports Med 1997; 25 (5) 692-698
  • 15 Canham W, Stanish W. A study of the biological behavior of the meniscus as a transplant in the medial compartment of a dog's knee. Am J Sports Med 1986; 14 (5) 376-379
  • 16 Mikic ZD, Brankov MZ, Tubic MV, Lazetic AB. Allograft meniscus transplantation in the dog. Acta Orthop Scand 1993; 64 (3) 329-332
  • 17 Lee DH, Kim TH, Lee SH, Kim CW, Kim JM, Bin SI. Evaluation of meniscus allograft transplantation with serial magnetic resonance imaging during the first postoperative year: focus on graft extrusion. Arthroscopy 2008; 24 (10) 1115-1121
  • 18 Verdonk P, Depaepe Y, Desmyter S , et al. Normal and transplanted lateral knee menisci: evaluation of extrusion using magnetic resonance imaging and ultrasound. Knee Surg Sports Traumatol Arthrosc 2004; 12 (5) 411-419
  • 19 Dienst M, Greis PE, Ellis BJ, Bachus KN, Burks RT. Effect of lateral meniscal allograft sizing on contact mechanics of the lateral tibial plateau: an experimental study in human cadaveric knee joints. Am J Sports Med 2007; 35 (1) 34-42
  • 20 Cole BJ, Carter TR, Rodeo SA. Allograft meniscal transplantation: background, techniques, and results. Instr Course Lect 2003; 52: 383-396
  • 21 Jackson DW, Whelan J, Simon TM. Cell survival after transplantation of fresh meniscal allografts. DNA probe analysis in a goat model. Am J Sports Med 1993; 21 (4) 540-550
  • 22 Rijk PC, Van Noorden CJF. Structural analysis of meniscal allografts after immediate and delayed transplantation in rabbits. Arthroscopy 2002; 18 (9) 995-1001