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J Knee Surg 2014; 27(06): 443-458
DOI: 10.1055/s-0034-1382080
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Meniscal Allograft Transplantation: Preoperative Assessment, Surgical Considerations, and Clinical Outcomes

Randy Mascarenhas
1   Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
,
Adam B. Yanke
1   Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
,
Rachel M. Frank
1   Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
,
Davietta C. Butty
1   Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
,
Brian J. Cole
2   Division of Sports Medicine, Department of Orthopedics, Rush University Medical Center, Chicago, Illinois
› Author Affiliations
Further Information

Publication History

14 March 2014

24 April 2014

Publication Date:
21 June 2014 (online)

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Abstract

The purpose of this review is to characterize the preoperative assessment of meniscal allograft transplantation (MAT) candidates, to detail MAT surgical techniques, and to evaluate current clinical outcome data on MAT. The MAT candidate is typically less than 50 years old and has a history of knee injury, previous meniscus surgery, and persistent pain. Physical exam generally reveals knee pain with joint line tenderness with normal radiographs and magnetic resonance imaging demonstrating the postmeniscectomized state. There are several common surgical techniques used for transplantation, with fixation achieved through sutures, bony fixation, or a combination of the two. Concomitant procedures such as anterior cruciate ligament reconstruction, osteotomy, and other cartilage procedures are commonly performed. The available short- and long-term studies of clinical outcomes of MAT are variable and difficult to effectively compare due to heterogeneity of the study population and available treatment techniques. In addition, there are no published randomized controlled trials. However, recent reviews and cohort studies of clinical outcomes following MAT have shown that whether performed in isolation or performed with concomitant articular cartilage, realignment, or soft tissue reconstruction procedures MAT outcomes have been acceptable with the majority of studies reporting improved clinical outcomes regardless of the scoring system employed. MAT has proven to be a safe and effective technique in reducing knee pain and improving function in the symptomatic meniscal deficient knee. Evaluation of long-term clinical outcomes is necessary as is evaluation of meniscal replacement alternatives.

Keywords

meniscal transplant - clinical outcomes - technique
 

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