Indications and limits of meniscal allografts.
Meniscal allograft transplantation has emerged as a useful treatment for carefully selected patients. The aim of this review of meniscal allograft transplantation is to put this procedure into a clinical perspective. Since there still is a lack of consensus on how the success of meniscal transplantation should be evaluated it is difficult to compare study outcomes. Nevertheless, almost all studies report an increase in patient satisfaction and improvement in pain and function. Clinical and functional outcome is improved in the majority of patients. Progression of cartilage degeneration according to MRI and radiological criteria was halted in a number of patients, indicating a chondroprotective effect. Joint space narrowing is only significantly progressive at long-term follow-up. On magnetic resonance imaging, shrinkage is seen after some years, but more in lyophilized allografts. Second-look arthroscopy usually shows good healing to the capsule. Overall, the clinical results of this type of surgery are encouraging and long-lasting in a well selected patient population who suffered a total meniscectomy. Meniscal allografting appears to becoming the golden standard therapy for these type of patients.
Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Gent, Belgium. rene.verdonk@ugent.be
R
R
Verdonk
P
P
Volpi
P
P
Verdonk
H
H
Van der Bracht
M
M
Van Laer
K F
KF
Almqvist
S
S
Vander Eecken
E
E
Prospero
A
A
Quaglia
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007593:Joint Instability / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology / Q000503:physiopathology / Q000637:transplantation*; D017060:Patient Satisfaction; D018579:Patient Selection; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D024162:Second-Look Surgery; D014184:Transplantation, Homologous; D016896:Treatment Outcome