title: Arthroscopic meniscal allograft transplantation with two tibia tunnels without bone plugs: evaluation of healing on MR arthrography and functional outcomes.
abstract: BACKGROUND
  Meniscal allograft transplantation seems to be a valid therapeutic option to restore the knee function and limit the development of osteoarthritis after menisectomy. No surgical technique has been shown to provide better results than others. The main objective of this study was to assess graft healing after arthroscopic meniscal allograft transplantation without bone plugs.
  
  
  METHODS
  This retrospective study included all patients who underwent arthroscopic meniscal allograft transplantation during 2005-2010. The meniscal horns were fixed through two tibia tunnels without bone plugs. The primary endpoint was graft healing according to Henning's criteria on MR arthrography (MRA) at 6-month follow-up. The secondary endpoints were the KOOS questionnaire, the IKDC score, measurement of the joint space and meniscal extrusion on both MRA at 6-month and MRI at last follow-up. The series included 22 patients, mean age 37 ± 7.5 years. The allograft was lateral in 20 cases and medial in 2 cases. The mean follow-up was 4.4 ± 1.6 years with one lost to follow-up.
  
  
  RESULTS
  MR arthrography was performed in 14/21 patients at 6-months of follow-up: 8/14 (57.1%) had total graft healing, 2/14 (14.3%) partial healing and 4/14 (28.6%) no healing. At final follow-up, all functional scores had significantly improved. The average pre- and post-operative joint space thickness was similar. MRI showed meniscal extrusion in 75% of patients.
  
  
  CONCLUSIONS
  The meniscal allograft transplantation without bone plugs effectively treats painful and functional sequellae of meniscectomies. The graft healed in most patients at 6-month follow-up. The long-term clinical relevance of meniscal extrusion has to be evaluated.
  
  
  METHODS
  Retrospective study, Level IV.
authors.affiliation: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, 92100, Boulogne-Billancourt, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Roumazeille
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Klouche
authors.forename: Benoit
authors.initials: B
authors.lastname: Rousselin
authors.forename: Vito
authors.initials: V
authors.lastname: Bongiorno
authors.forename: Nicolas
authors.initials: N
authors.lastname: Graveleau
authors.forename: Nicolas
authors.initials: N
authors.lastname: Billot
authors.forename: Philippe
authors.initials: P
authors.lastname: Hardy
mesh_terms: D000328:Adult; D064591:Allografts; D001175:Arthrography; D001182:Arthroscopy; D001843:Bone Cements; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery; D014184:Transplantation, Homologous; D014945:Wound Healing
chemical_list: D001843:Bone Cements