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Tear patterns and locations are different between lateral and medial compartments in patients with early anatomical failure after meniscal allograft transplantation

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To investigate the characteristics of anatomically failed grafts within 1 year after meniscal allograft transplantation (MAT) and compare the differences between lateral and medial MATs.

Methods

The records of consecutive patients with anatomically failed grafts within 1 year after primary MAT between 2005 and 2018 were reviewed. Anatomical failure was defined as a tear covering > 50% of the allograft or an unstable peripheral rim. The pattern and location of the graft tears were analyzed using magnetic resonance imaging or arthroscopy.

Results

A total of 21 patients were included. All 21 patients had anatomical failure with tears involving > 50% of the allograft, whereas 15 had an unstable peripheral rim of the allograft. The mean failure time was 6.6 ± 3.6 months in all patients (lateral MAT, n = 15; medial MAT, n = 6). In the lateral MAT group, meniscocapsular separation was the most common pattern (n = 10, 66.7%), followed by complex (n = 3, 20.0%), radial (n = 1, 6.7%), and longitudinal (n = 1, 6.7%) tear. In the medial MAT group, a root tear was the most common pattern (n = 5, 83.3%), followed by a complex tear (n = 1, 16.7%). Meanwhile, in the lateral MAT, the midbody was the most frequently affected location (n = 9, 60.0%), followed by the posterior (n = 5, 33.3%) and anterior (n = 1, 6.7%) areas; in the medial MAT group, the posterior (n = 5, 83.3%) was the most frequently affected location, followed by the anterior area (n = 1, 16.7%). Significant differences in the pattern (P = 0.002) and location (P = 0.043) of the graft tears were found between lateral and medial MATs.

Conclusion

In patients with early failure after MAT, meniscocapsular separation in the midbody of the lateral compartment and root tears in the posterior area of the medial compartment were the most common. Thus, surgeons are encouraged to pay extra attention to these vulnerable areas during the early period after MAT.

Level of evidence

IV.

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Abbreviations

ACL:

Anterior cruciate ligament

BMI:

Body mass index

HTO:

High tibial osteotomy

ICRS:

International Cartilage Regeneration & Joint Preservation Society

ISAKOS:

International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine

MAT:

Meniscal allograft transplantation

MRI:

Magnetic resonance imaging

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 43 Gil, Songpa-gu, 05505, Seoul, Republic of Korea

    Seon-Jong Lee, Seong-Il Bin, Jong-Min Kim & Bum-Sik Lee

  2. Department of Orthopaedic Surgery, Wiltse memorial hospital, Anyang, Republic of Korea

    Seung-Min Kim

  3. Daejeon Eulji University Hospital, Daejeon, Republic of Korea

    Hyo Yeol Lee

Authors
  1. Seon-Jong Lee
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  2. Seong-Il Bin
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  4. Bum-Sik Lee
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Contributions

SJL contributed to the drafting of the manuscript. SIB has made substantial contribution to study conception, design, and data acquisition. JMK contributed to the study design and data interpretation. BSL participated in the study design and data interpretation. SMK and HYL participated in data analysis and interpretation. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Seong-Il Bin.

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Conflict of interest

Each author certifies that he has no commercial associations that might pose a conflict of interest in connection with the submitted article.

Ethical approval

This study was approved by our institutional review board (Approval no. 2022-0414).

IRB information

The study was approved by the Asan Medical Center Institutional Review Board (Receipt no. S2022-0290-0001, Project no. 2022-0414).

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Lee, SJ., Bin, SI., Kim, JM. et al. Tear patterns and locations are different between lateral and medial compartments in patients with early anatomical failure after meniscal allograft transplantation. Knee Surg Sports Traumatol Arthrosc 31, 4485–4491 (2023). https://doi.org/10.1007/s00167-023-07506-9

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