title: Is Sport Activity Possible After Arthroscopic Meniscal Allograft Transplantation? Midterm Results in Active Patients.
abstract: BACKGROUND
  Meniscal allograft transplantation (MAT) has produced good to excellent results in the general population; however, few investigations have examined MAT in athletes and sport-related outcomes.
  
  
  OBJECTIVE
  To report midterm clinical outcomes of MAT and the rate of return to sport in a physically active population.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  The study included all physically active patients who underwent arthroscopic MAT without bone plugs and had a minimum of 2 years of follow-up at a single institution. Clinical evaluation was performed with the Knee injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity scale, and a 0- to 100-point subjective scale for knee function and satisfaction. Outcomes evaluated included ability to return to sport, time to return to sport, level of sport activity upon return compared with preinjury level, and level of decrease in sport participation or reasons for not returning to sport participation. Comparisons were made between patients who did or did not return to sport and between patients who returned to the same level or a decreased level. Regression analysis was performed to determine the variables affecting the outcomes.
  
  
  RESULTS
  Eighty-nine patients, whose mean ± SD age at surgery was 38.5 ± 11.2 years, were evaluated to a mean follow-up of 4.2 ± 1.9 years. Total KOOS improved from a mean ± SD of 39.5 ± 18.5 preoperatively to 84.7 ± 14.8 at the latest follow-up (P < .001). The Tegner score improved significantly from a median of 2 (interquartile range [IQR], 1-4) preoperatively to a median of 4 (IQR, 3-6) at the latest follow-up (P < .001), although it did not reach the preinjury level of 6 (IQR, 5-7) (P < .001). Older age at surgery was correlated with the worst clinical results. Sixty-six patients (74%) were able to return to sport after 8.6 ± 4.1 months. Forty-four (49%) returned to the same level as preinjury. Patients who did not return to sport activity and those who reduced their activity level at follow-up had inferior subjective outcomes compared with those who returned to sport and those who returned to their preinjury levels, respectively. Only 11 patients (12%) underwent a surgical procedure during the follow-up period.
  
  
  CONCLUSIONS
  Arthroscopic MAT without bone plugs improved knee function and reduced pain, allowing sport resumption in 74% of patients and return to the preinjury activity level in 49% of patients at midterm follow-up. Of all the demographic and surgical variables, only age at surgery seemed to affect outcomes.
authors.affiliation: II Clinica Ortopedica e Traumatologica, Laboratorio di Biomeccanica, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Zaffagnini
authors.affiliation: II Clinica Ortopedica e Traumatologica, Laboratorio di Biomeccanica, Istituto Ortopedico Rizzoli, Bologna, Italy alberto.grassi@ior.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Grassi
authors.affiliation: II Clinica Ortopedica e Traumatologica, Laboratorio di Biomeccanica, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Giulio Maria
authors.initials: GM
authors.lastname: Marcheggiani Muccioli
authors.affiliation: II Clinica Ortopedica e Traumatologica, Laboratorio di Biomeccanica, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Benzi
authors.affiliation: II Clinica Ortopedica e Traumatologica, Laboratorio di Biomeccanica, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Roberti di Sarsina
authors.affiliation: Laboratorio di Biomeccanica, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Signorelli
authors.affiliation: II Clinica Ortopedica e Traumatologica, Laboratorio di Biomeccanica, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Raggi
authors.affiliation: II Clinica Ortopedica e Traumatologica, Laboratorio di Biomeccanica, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts / Q000502:physiology; D018771:Arthralgia / Q000209:etiology / Q000503:physiopathology; D001265:Athletic Injuries / Q000601:surgery*; D002358:Cartilage, Articular / Q000293:injuries / Q000502:physiology; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000637:transplantation*; D063868:Patient Outcome Assessment; D020127:Recovery of Function; D012189:Retrospective Studies; D000068958:Return to Sport / Q000502:physiology; D013997:Time Factors; D014184:Transplantation, Homologous; D055815:Young Adult
keywords: allograft; arthroscopy; knee; meniscus; replacement; sport activity; transplantation