Abstract
Introduction
Meniscus deficiency leads to the development of early arthritis. Total knee replacement may be the only available treatment option in certain situations. However it is generally best avoided in young patients. We hypothesized that a combination of the two procedures, Allograft Meniscal Transplantation (AMT) and Autologous Chondrocyte Implantation (ACI) would be a solution to treat bone-on-bone arthritis in meniscal deficient knees and postpone the need for a total knee replacement (TKR).
Materials/Methods
12 consecutive patients who underwent both ACI and AMT between 1998 and 2005 were followed up prospectively. The patients were assessed by a self-assessed Lysholm score prior to the procedure and yearly thereafter. All operations were performed by the senior author (JBR). ACI procedure was performed according to the standard technique. Frozen meniscal allograft with bone plugs at either ends secured by sutures in the bone tunnels. Post operatively all patients underwent a strict Oscell Rehabilitation protocol. A repeat procedure or progression to a TKR was taken as a failure.
Results
Out of the twelve patients only eleven were included as one had died at three months after surgery. Three patients had delayed TKR, and two were heading towards TKR at 8 years. The median pre-operative lysholm score in the remaining six patients rose from 45 to 64 at last follow up.
Conclusions
In our small pilot study there was a 19 point increase in the lysholm score. The combination of ACI & AMT could give a good result defer the need for TKR.
