Meniscal allograft transplantation--part I: background, results, graft selection and preservation, and surgical considerations.
Removal of the meniscus leads to progressive degenerative arthritis of the knee on a long-term basis. Therefore, meniscal allograft transplantation has been proposed as an alternative to meniscectomy. Although several experimental and clinical studies have documented that meniscal allografts show capsular ingrowth in meniscectomized knees, it remains to be established whether meniscal allograft transplantation can prevent degenerative changes after meniscectomy. Part 1 of this Current Concepts review will discuss the function, anatomy, and composition of the meniscus, followed by the history of surgery of meniscal tears and the healing of meniscal allografts in experimental and clinical studies. In addition, issues concerning preservation techniques, immunological reactions, sizing, disease transmission, indications, surgical technique, graft fixation, rehabilitation, and complications, will be taken into consideration. It can be concluded that the use of meniscal allografts in clinical practice has progressed to a point where relief of pain may be expected for the short-term.
Rijk
Paul C
PC
Department of Orthopaedic Surgery, Medical Centre Leeuwarden, Postbus 888, 8901 BR Leeuwarden, The Netherlands. pcrijk@planet.nl
D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D001696:Biomechanical Phenomena; D002470:Cell Survival; D019902:Chondrocytes / Q000166:cytology / Q000637:transplantation; D004285:Dogs; D006041:Goats; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival; D006801:Humans; D007239:Infections / Q000635:transmission; D008592:Menisci, Tibial / Q000276:immunology / Q000601:surgery / Q000637:transplantation*; D023421:Models, Animal; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods / Q000534:rehabilitation; D012756:Sheep; D000070600:Tibial Meniscus Injuries; D014021:Tissue Preservation / Q000379:methods; D020858:Tissue and Organ Harvesting / Q000379:methods; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome