A prospective outcomes study of meniscal allograft transplantation.
BACKGROUND
Symptomatic early-onset chondromalacia often develops after a meniscectomy in the affected knee compartment. The role of meniscal transplantation in reducing pain and improving function in patients with prior ipsilateral meniscectomy is still being defined.


OBJECTIVE
Patients with symptomatic early-onset chondromalacia of the knee after ipsilateral meniscectomy will have improved clinical outcomes after meniscal transplantation.


METHODS
Case series; Level of evidence, 4.


METHODS
All patients who underwent meniscal allograft transplantation between July 2003 and December 2006 were prospectively followed. The indications for surgery were unicompartmental knee pain and postactivity effusions after total or near-total meniscectomy in patients with closed physes. High-field magnetic resonance imaging (1.5-T or 3-T magnets) was used to assess the articular cartilage of the affected compartment. The meniscal transplantations were performed with an arthroscopically assisted technique. Modified Cincinnati knee and International Knee Documentation Committee (IKDC) subjective and IKDC objective outcome scores were obtained on all patients preoperatively and postoperatively to evaluate patients' outcomes.


RESULTS
Forty patients with an average age of 25 years and a body mass index of 25.4 were included. After an average final follow-up of 2.5 years, IKDC subjective scores increased significantly from 54.5 to 72.0 (P < .001). Modified Cincinnati knee scores increased from 55.2 to 75.3 (P < .001). The preoperative IKDC objective scores measuring effusion improved significantly from 6 A (normal), 29 B (nearly normal), and 5 C (abnormal), when compared with the postoperative scores of 33 A (normal) and 1 B (nearly normal) (P < .01). Five patients sustained tears of their meniscal transplants and underwent partial meniscectomies of the transplant graft.


CONCLUSIONS
The results confirm that meniscal transplantation significantly reduces pain, decreases activity-related effusions, and improves function in patients with prior meniscectomy; however, the long-term chondroprotective effects remain unknown.
LaPrade
Robert F
RF
Biomechanics Department, Steadman Philippon Research Institute, The Steadman Clinic, 181 W. Meadow Drive, Suite 400, Vail, CO 81657, USA. drlaprade@sprivail.org
Wills
Nicholas J
NJ
Spiridonov
Stanislav I
SI
Perkinson
Scott
S
D000293:Adolescent; D000328:Adult; D002357:Cartilage Diseases / Q000209:etiology / Q000601:surgery; D002358:Cartilage, Articular / Q000601:surgery*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000150:complications / Q000601:surgery; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000637:transplantation*; D008875:Middle Aged; D019637:Orthopedic Procedures; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult