Abstract
Background
There is growing evidence in literature that meniscal allograft transplantation performed with the right indications results in significant pain relief and functional improvement of the involved joint. Long-term data on clinical and radiological outcome are however scarce.
Methods
We evaluated 89 transplants (53 lateral and 36 medial) in 87 patients. Mean time of follow-up was 15,5 ± 2,85 years (range 9,9–20,4), mean age at surgery was 35,2 years (range 22–50). Clinically, the patients were evaluated using a KOOS, SF-36, HSS, VAS, Tegner and Lysholm score. HSS scores were compared to pre-operative and mid-term follow-up data. Each patient received radiographs (AP, profile and Rosenberg view). Radiological outcome parameters were joint space width narrowing and Fairbank changes and were scored according to IKDC. Failures were defined as patients who were converted to an arthroplasty.
Results
HSS-scores improved significantly from 119 ± 27pre-operatively to 160 ± 40 at long-term follow-up. Lysholm-score was 69 ± 22, which was defined as a fair result. Mean VAS-score was 3,4 ± 3, mean Tegner was 4 ± 2. There were no significant differences between following subgroups: left or right knee, medial or lateral allograft, combined procedure with a high tibial osteotomy and male or female. Nine (25%) of the thirty-six medial and ten (19%) of the fifty-three lateral grafts failed after a mean of 9,9 years.
Conclusions
Transplantation of a viable meniscal allograft can significantly relieve pain and improve function of the knee joint. Survival analysis showed that this beneficial effect remained in approximately 70% of the patients at fifteen years. This study proves that meniscal allograft transplantation is a beneficial procedure to postpone total knee arthroplasty for more than 10 years in young active patients.
