title: Results of meniscus allograft transplantation using bone fixation: 110 cases with objective evaluation.
abstract: BACKGROUND
  Meniscus allograft transplantation (MAT) has shown efficacy in relieving pain and improving knee joint function, but objective evaluation in a large number of patients is necessary to verify this effect.
  
  
  OBJECTIVE
  Meniscus allograft transplantation relieves pain and improves function of the involved knee joint. Objective evaluation provides evidence of allograft integrity.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Of the 115 knees that underwent MAT from December 1996 to February 2009, 110 (95.7%) were followed up for more than 2 years and were enrolled in this study. Of these, 83 underwent lateral MAT, and 27 underwent medial MAT. Clinical outcomes were evaluated using the modified Lysholm score and Knee Society pain score. All knees underwent postoperative magnetic resonance imaging (MRI) and/or second-look arthroscopy to evaluate the integrity and position of the allografts, with allograft status classified as satisfactory, fair, or poor.
  
  
  RESULTS
  At a mean follow-up of 49.4 months, clinical improvement was achieved in 104 of the 110 knees (94.5%). Mean modified Lysholm score increased from 72.7 preoperatively to 92.3 at final follow-up (P < .001), and mean preoperative Knee Society pain score increased from 32.5 to 47.7 (P < .001). Of the 110 knees, 90 were evaluated by postoperative MRI alone, 2 by second-look arthroscopy alone, and 18 by both. Magnetic resonance imaging showed 12 gross tears and 6 small tears in the allograft. Mean extrusion of the allograft was 3.7 mm, and mean relative percentage of extrusion was 42.6%. Second-look arthroscopy showed 6 gross tears and 1 small flap tear. Classification by clinical outcome, MRI, and second-look arthroscopy graded 90 allografts (81.8%) as satisfactory, 8 (7.3%) as fair, and 12 (10.9%) as poor.
  
  
  CONCLUSIONS
  Meniscus allograft transplantation using bone fixation resulted in significant symptomatic and functional improvements. Magnetic resonance imaging or second-look arthroscopy was necessary to assess allograft status even after favorable clinical outcome. Meniscus allograft transplantation with bone fixation is considered effective for symptomatic, totally meniscectomized knees.
authors.affiliation: Department of Orthopedic Surgery, University of Ulsan, Seoul, Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Kim
authors.forename: Bum-Sik
authors.initials: BS
authors.lastname: Lee
authors.forename: Keong-Hwan
authors.initials: KH
authors.lastname: Kim
authors.forename: Kyung-Ah
authors.initials: KA
authors.lastname: Kim
authors.forename: Seong-Il
authors.initials: SI
authors.lastname: Bin
mesh_terms: D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000209:etiology / Q000601:surgery; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007718:Knee Injuries / Q000150:complications / Q000534:rehabilitation / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery / Q000637:transplantation*; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D020127:Recovery of Function; D012189:Retrospective Studies; D000070600:Tibial Meniscus Injuries; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult