Long-term survival of concurrent meniscus allograft transplantation and repair of the articular cartilage: a prospective two- to 12-year follow-up report.
We describe 119 meniscal allograft transplantations performed concurrently with articular cartilage repair in 115 patients with severe articular cartilage damage. In all, 53 (46.1%) of the patients were over the age of 50 at the time of surgery. The mean follow-up was for 5.8 years (2 months to 12.3 years), with 25 procedures (20.1%) failing at a mean of 4.6 years (2 months to 10.4 years). Of these, 18 progressed to knee replacement at a mean of 5.1 years (1.3 to 10.4). The Kaplan-Meier estimated mean survival time for the whole series was 9.9 years (sd 0.4). Cox's proportional hazards model was used to assess the effect of covariates on survival, with age at the time of surgery (p = 0.026) and number of previous operations (p = 0.006) found to be significant. The survival of the transplant was not affected by gender, the severity of cartilage damage, axial alignment, the degree of narrowing of the joint space or medial versus lateral allograft transplantation. Patients experienced significant improvements at all periods of follow-up in subjective outcome measures of pain, activity and function (all p-values < 0.05), with the exception of the seven-year Tegner index score (p = 0.076).
Stone
K R
KR
The Stone Research Foundation, San Francisco, CA, USA. kstonemd@stoneclinic.com
Adelson
W S
WS
Pelsis
J R
JR
Walgenbach
A W
AW
Turek
T J
TJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data; D001182:Arthroscopy / Q000379:methods; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006085:Graft Survival; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000637:transplantation*; D008875:Middle Aged; D011859:Radiography; D012086:Reoperation / Q000706:statistics & numerical data; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult