title: Triad of cartilage restoration for unicompartmental arthritis treatment in young patients: meniscus allograft transplantation, cartilage repair and osteotomy.
abstract: Arthritis treatment in young patients remains a challenge. Joint replacement surgery offers excellent pain relief but is controversial with this age group because of long-term wear and loosening. Recently, biological reconstructive techniques have become available to improve traditional treatment methods such as osteotomies. We present our experience with a technique for combined meniscal transplantation, chondral repair, and osteotomy in 7 patients presenting with a constellation of meniscal deficiency, focal arthritis, and malalignment. Patients underwent concurrent or staged meniscal transplantation, cartilage repair, and osteotomy. Evaluation included the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Short Form-12 and Lysholm scales. At average follow-up of 24 months, patients experienced significant improvements in the IKDC, Lysholm, and KOOS functional scores. Six of 7 patients were able to return to unrestricted activities; 1 patient experienced mild pain with high-impact activities. Combined treatment with meniscal transplantation, cartilage repair, and osteotomy demonstrated promising clinical results of unicompartmental arthritis treatment in young patients.
authors.affiliation: Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, USA.
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Gomoll
authors.forename: Richard W
authors.initials: RW
authors.lastname: Kang
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Chen
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
mesh_terms: D000293:Adolescent; D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D001182:Arthroscopy / Q000379:methods; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology / Q000601:surgery* / Q000637:transplantation; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D017060:Patient Satisfaction; D011788:Quality of Life; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome