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DOI: 10.1055/s-0039-1695041
Obesity and Meniscal Transplant Failure: A Retrospective Cohort Study
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Abstract
The purpose of this study was to analyze the effect of obesity and other clinical factors on the outcome of meniscal allograft transplantation (MAT) with transosseous fixation. A retrospective cohort study was performed on patients who underwent a MAT between 2002 and 2017. All the participants had a minimum follow-up period of 24 months. The variables assessed were age at the time of the transplant, side, sex, transplanted meniscus (lateral/medial), body mass index (BMI), smoking status, and previous surgeries. Lysholm, Tegner, and International Knee Documentation Committee (IKDC) test outcomes, and patient satisfaction were recorded. Image assessment was performed using plain standing X-rays and a follow-up magnetic resonance imaging scan. Thirty-five patients fulfilled the inclusion criteria. The mean follow-up time was of 75.7 standard deviation (SD) 43.4 months. Patients with a BMI ≥ 30 underwent medial meniscal transplants (88.9 vs. 42.3%, p = 0.022, respectively) more frequently. Obese patients had a significantly lower IKDC (48.6 SD 19.9 vs. 61.7 SD 13.1, p = 0.038, power: 57.5%) and Lysholm (60.3 SD 19.2 vs. 79.4 SD 14.3, p = 0.004, power: 88.7%) scores compared with nonobese patients. The satisfaction and Tegner scores were also lower in obese patients (55.6 vs. 80.7%, p = 0.136, and 2.8 SD 1.0 vs. 4.0 SD 1.9, p = 0.104, respectively); however, these differences were not statistically significant. Obese patients had higher rates of meniscal transplant failure compared with nonobese patients (adjusted hazard ratio: 11.8 [95% confidence interval: 1.5–91.4]). No differences were observed between obese and nonobese patients regarding age, sex, side, smoking status, and follow-up time. In this study, a BMI ≥ 30 kg/m2 resulted in higher MAT failure rates. Nonobese patients had better knee functional results compared with obese individuals.
Publication History
Received: 26 October 2018
Accepted: 03 July 2019
Article published online:
21 August 2019
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References
- 1 Elattar M, Dhollander A, Verdonk R, Almqvist KF, Verdonk P. Twenty-six years of meniscal allograft transplantation: is it still experimental? A meta-analysis of 44 trials. Knee Surg Sports Traumatol Arthrosc 2011; 19 (02) 147-157
- 2 Sekiya JK, Ellingson CI. Meniscal allograft transplantation. J Am Acad Orthop Surg 2006; 14 (03) 164-174
- 3 Caldwell III PE, Shelton WR. Indications for allografts. Orthop Clin North Am 2005; 36 (04) 459-467
- 4 Verdonk R. Alternative treatments for meniscal injuries. J Bone Joint Surg Br 1997; 79 (05) 866-873
- 5 Rijk PC. Meniscal allograft transplantation--part I: background, results, graft selection and preservation, and surgical considerations. Arthroscopy 2004; 20 (07) 728-743
- 6 Dirisamer F, Patsch C. Preoperative issues: patient selection. In: Getgood A, Spalding T, Cole B, Gersoff W, Verdonk P. eds. Meniscal Allograft Transplantation. A Comprehensive Review. Guildford: DJO Publications; 2015: 77-84
- 7 Cole BJ, Carter TR, Rodeo SA. Allograft meniscal transplantation: background, techniques, and results. Instr Course Lect 2003; 52: 383-396
- 8 Graf Jr KW, Sekiya JK, Wojtys EM. Department of Orthopaedic Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, USA. Long-term results after combined medial meniscal allograft transplantation and anterior cruciate ligament reconstruction: minimum 8.5-year follow-up study. Arthroscopy 2004; 20 (02) 129-140
- 9 Vundelinckx B, Bellemans J, Vanlauwe J. Arthroscopically assisted meniscal allograft transplantation in the knee: a medium-term subjective, clinical, and radiographical outcome evaluation. Am J Sports Med 2010; 38 (11) 2240-2247
- 10 De Bruycker M, Verdonk PCM, Verdonk RC. Meniscal allograft transplantation: a meta-analysis. SICOT J 2017; 3: 33
- 11 Finucane MM, Stevens GA, Cowan MJ. et al. Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass Index). National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet 2011; 377 (9765): 557-567
- 12 Sommerfeldt MF, Magnussen RA, Randall KL. et al. The relationship between body mass index and risk of failure following meniscus repair. J Knee Surg 2016; 29 (08) 645-648
- 13 Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res (Hoboken) 2011; 63 (Suppl. 11) S208-S228
- 14 Myers P, Tudor F. Meniscal allograft transplantation: how should we be doing it? A systematic review. Arthroscopy 2015; 31 (05) 911-925
- 15 Rosso F, Bisicchia S, Bonasia DE, Amendola A. Meniscal allograft transplantation: a systematic review. Am J Sports Med 2015; 43 (04) 998-1007
- 16 Smith NA, MacKay N, Costa M, Spalding T. Meniscal allograft transplantation in a symptomatic meniscal deficient knee: a systematic review. Knee Surg Sports Traumatol Arthrosc 2015; 23 (01) 270-279
- 17 Saltzman BM, Bajaj S, Salata M. et al. Prospective long-term evaluation of meniscal allograft transplantation procedure: a minimum of 7-year follow-up. J Knee Surg 2012; 25 (02) 165-175
- 18 Cole BJ, Dennis MG, Lee SJ. et al. Prospective evaluation of allograft meniscus transplantation: a minimum 2-year follow-up. Am J Sports Med 2006; 34 (06) 919-927
- 19 Verdonk PC, Verstraete KL, Almqvist KF. et al. Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations. Knee Surg Sports Traumatol Arthrosc 2006; 14 (08) 694-706
- 20 Chatain F, Adeleine P, Chambat P, Neyret P. Société Française d'Arthroscopie. A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy 2003; 19 (08) 842-849
- 21 Peña E, Calvo B, Martinez MA, Palanca D, Doblaré M. Why lateral meniscectomy is more dangerous than medial meniscectomy. A finite element study. J Orthop Res 2006; 24 (05) 1001-1010
- 22 Stone KR, Walgenbach AW, Turek TJ, Freyer A, Hill MD. Meniscus allograft survival in patients with moderate to severe unicompartmental arthritis: a 2- to 7-year follow-up. Arthroscopy 2006; 22 (05) 469-478
- 23 Spahn G, Mückley T, Kahl E, Hofmann GO. Factors affecting the outcome of arthroscopy in medial-compartment osteoarthritis of the knee. Arthroscopy 2006; 22 (11) 1233-1240
- 24 Englund M, Felson DT, Guermazi A. et al. Risk factors for medial meniscal pathology on knee MRI in older US adults: a multicentre prospective cohort study. Ann Rheum Dis 2011; 70 (10) 1733-1739
- 25 Ford GM, Hegmann KT, White Jr GL, Holmes EB. Associations of body mass index with meniscal tears. Am J Prev Med 2005; 28 (04) 364-368
- 26 Laberge MA, Baum T, Virayavanich W. et al. Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects--data from the Osteoarthritis Initiative. Skeletal Radiol 2012; 41 (06) 633-641
- 27 Bout-Tabaku S, Shults J, Zemel BS. et al. Obesity is associated with greater valgus knee alignment in pubertal children, and higher body mass index is associated with greater variability in knee alignment in girls. J Rheumatol 2015; 42 (01) 126-133
- 28 Abat F, Gelber PE, Erquicia JI, Pelfort X, Gonzalez-Lucena G, Monllau JC. Suture-only fixation technique leads to a higher degree of extrusion than bony fixation in meniscal allograft transplantation. Am J Sports Med 2012; 40 (07) 1591-1596
- 29 Ha JK, Shim JC, Kim DW, Lee YS, Ra HJ, Kim JG. Relationship between meniscal extrusion and various clinical findings after meniscus allograft transplantation. Am J Sports Med 2010; 38 (12) 2448-2455
- 30 Masferrer-Pino A, Monllau JC, Ibáñez M, Erquicia JI, Pelfort X, Gelber PE. Capsulodesis versus bone trough technique in lateral meniscal allograft transplantation: graft extrusion and functional results. Arthroscopy 2018; 34 (06) 1879-1888
- 31 Cummins JF, Mansour JN, Howe Z, Allan DG. Meniscal transplantation and degenerative articular change: an experimental study in the rabbit. Arthroscopy 1997; 13 (04) 485-491
- 32 Crook TB, Ardolino A, Williams LA, Barlow IW. Meniscal allograft transplantation: a review of the current literature. Ann R Coll Surg Engl 2009; 91 (05) 361-365
- 33 Matava MJ. Meniscal allograft transplantation: a systematic review. Clin Orthop Relat Res 2007; 455 (455) 142-157