title: Medial meniscus allograft transplantation using a modified bone plug technique: clinical, radiologic, and arthroscopic results.
abstract: OBJECTIVE
  To determine clinical, radiologic, and arthroscopic results of our meniscus allograft transplantation (MAT) by use of modified bone plug technique, which permits easy passage of the allograft by reducing the size of the posterior bone plug.
  
  
  METHODS
  From December 2004 to December 2008, 22 consecutive patients (20 men and 2 women) with a mean age of 35.9 years underwent medial MAT with the modified bone plug method. The Lysholm score and International Knee Documentation Committee subjective knee score were documented. Joint space narrowing and Kellgren-Lawrence grade changes were evaluated on radiographs, and graft healing status, arthrosis changes in cartilage, and meniscal extrusion were investigated by magnetic resonance imaging (MRI).
  
  
  RESULTS
  The mean follow-up was 24.9 months. The mean Lysholm score improved significantly, from 68.2 to 89.7 (P = .002). The International Knee Documentation Committee subjective knee score improved significantly, from 60.3 to 85.4 (P = .003). Joint space narrowing was insignificant, and arthrosis progression was observed in 3 of 22 cases (13.6%) on radiographs. On MRI, complete healing of the grafts was observed in 18 cases (100%), 15 cases (83.3%), and 17 cases (94.4%) at the anterior root, posterior root, and meniscal rim, respectively. Mean meniscal extrusion was 4.35 ± 1.76 mm, and arthrosis progression was observed in 4 of 18 cases (22.2%). During second-look arthroscopy, complete healing of the grafts was observed in 11 cases (100%), 9 cases (81.8%), and 10 cases (90.9%) at the anterior root, posterior root, and meniscal rim, respectively. Cartilage degeneration was advanced in 4 cases (36.4%). No significant correlations were found between meniscal extrusion and other outcomes.
  
  
  CONCLUSIONS
  Our modified bone plug method was an effective surgical method. MRI and second-look arthroscopic examinations showed sound evidence of graft healing. Meniscal extrusion was observed in most cases but was not correlated with other clinical and radiologic outcomes.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, South Korea.
authors.forename: Jeong Ku
authors.initials: JK
authors.lastname: Ha
authors.forename: Jung Hwan
authors.initials: JH
authors.lastname: Sung
authors.forename: Jae Chan
authors.initials: JC
authors.lastname: Shim
authors.forename: Jeong Gook
authors.initials: JG
authors.lastname: Seo
authors.forename: Jin Goo
authors.initials: JG
authors.lastname: Kim
mesh_terms: D000328:Adult; D001182:Arthroscopy; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology / Q000637:transplantation*; D008875:Middle Aged; D024162:Second-Look Surgery; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult