title: Meniscal allograft transplantation in a symptomatic meniscal deficient knee: a systematic review.
abstract: OBJECTIVE
  The primary objective of this study was to perform an updated systematic review and meta-analysis of meniscal allograft transplantation using patient reported outcome measures at final follow-up as the outcome tool. The secondary objective was to provide an up to date review of the indications, associated procedures, operative technique, rehabilitation, failures, complications, radiological outcomes, and graft healing.
  
  
  METHODS
  Medline, Embase and CENTRAL databases, trials registries, and Web-of Science were searched for studies using pre-defined eligibility criteria. Included studies were reviewed with Lysholm, International Knee Documentation Committee (IKDC) and Tegner scores, failures and complications pooled. Studies were also qualitatively assessed.
  
  
  RESULTS
  There were 1,332 patients (1,374 knees) in 35 studies eligible for analysis. The mean follow-up was 5.1 years. Across all studies, Lysholm scores improved from 55.7 to 81.3, IKDC scores from 47.0 to 70.0, and Tegner activity scores from 3.1 to 4.7 between pre-operative and final follow-up assessments, respectively. The mean failure rate across all studies was 10.6% at 4.8 years, and complication rate was 13.9% at 4.7 years. There is a high risk of bias across the studies due to study design and missing outcomes.
  
  
  CONCLUSIONS
  Based on current evidence, meniscal allograft transplantation appears to be an effective intervention for patients with a symptomatic meniscal deficient knee. This should ideally be confirmed with a randomised controlled trial. There is not currently enough evidence to determine whether it is chondroprotective.
authors.affiliation: Clinical Sciences Research Laboratories, University of Warwick, Clifford Bridge Road, Coventry, CV2 2DX, UK, nickasmith@doctors.net.uk.
authors.forename: Nick A
authors.initials: NA
authors.lastname: Smith
authors.forename: Nicola
authors.initials: N
authors.lastname: MacKay
authors.forename: Matthew
authors.initials: M
authors.lastname: Costa
authors.forename: Tim
authors.initials: T
authors.lastname: Spalding
mesh_terms: D064591:Allografts; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D008592:Menisci, Tibial / Q000601:surgery* / Q000637:transplantation; D063868:Patient Outcome Assessment; D000070600:Tibial Meniscus Injuries; D014184:Transplantation, Homologous