Meniscal allograft with or without osteotomy: a 15-year follow-up study
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To assess survivorship of meniscal allografts and the benefit of concomitant osteotomy.
A retrospective review was performed of all patients who had meniscal allograft surgery ± osteotomy. Fresh frozen meniscal allograft was sutured in place using an onlay technique. Osteotomies were performed in patients with malalignment. We recorded any further intervention required. Survivorship was assessed defining failure as being scheduled or having received a total knee arthroplasty (TKA).
Mean age was 40 years. Primary diagnosis was degeneration after previous meniscal injury. Eighty-six allografts were performed, 43 of the medial meniscus and 41 of the lateral meniscus. One patient had implantation of both medial and lateral menisci. Simultaneous osteotomy was performed in 53 patients. Seven patients underwent simultaneous anterior cruciate ligament reconstruction. Mean follow-up was 180 months. At the time of writing, 61 allografts (71 %) remain in situ with adequate function. Fifteen allografts required arthroscopy and meniscal debridement at a mean of 68 months postop. Twenty-four allografts (28 %) went on to degenerate and required TKA at a mean of 149 months postop. There was no significant difference in the survival for isolated allograft ± osteotomy of either the medial meniscus, lateral meniscus or patients requiring arthroscopic intervention (n.s.).
Meniscal allograft is a viable solution to meniscal loss in the young patient. Survivorship is good, providing a mean of 12.4 years prior to TKA in those requiring conversion with 71 % of allografts still in situ at a mean of 15 years post-surgery.
Level of evidence
Therapeutic, retrospective, Level IV.
KeywordsMeniscus Allograft Osteotomy Malalignment Survivorship
HAK received financial assistance in the form of the Charnley-Latta Travelling Scholarship. He is grateful to the donors and trustees for their assistance.
Conflict of interest
The authors state that they have no conflict of interest.
- 5.Cameron JC, Saha S (1997) Meniscal allograft transplantation for unicompartmental arthritis of the knee. Clin Orthop Relat Res 337:164–171Google Scholar
- 8.Drexler M, Dwyer T, Dolkart O, Goldstein Y, Steinberg EL, Chakravertty R, Cameron JC (2013) Tibial rotational osteotomy and distal tuberosity transfer for patella subluxation secondary to excessive external tibial torsion: surgical technique and clinical outcome. Knee Surg Sports Traumatol Arthrosc. doi: 10.1007/s00167-013-2561-5 Google Scholar
- 9.Drexler M, Gross A, Dwyer T, Safir O, Backstein D, Chaudhry H, Goulding A, Kosashvili Y (2014) Distal femoral varus osteotomy combined with tibial plateau fresh osteochondral allograft for post-traumatic osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc doi: 10.1007/s00167-013-2828-x
- 18.NJR Committee (2013) Revisions after primary knee surgery by main brands for TKR and UKR. National Joint Registry Report for England, Wales and Northern Ireland 10th Annual Report, pp 173–175Google Scholar
- 19.Paley D, Tetsworth K (1992) Mechanical axis deviation of the lower limbs. Preoperative planning of multiapical frontal plane angular and bowing deformities of the femur and tibia. Clin Orthop Relat Res 280:65–71Google Scholar
- 24.Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49Google Scholar
- 29.Zaffagnini S, Marcheggiani Muccioli GM, Lopomo N, Bruni D, Giordano G, Ravazzolo G, Molinari M, Marcacci M (2011) Prospective long-term outcomes of the medial collagen meniscus implant versus partial medial meniscectomy: a minimum 10-year follow-up study. Am J Sports Med 39:977–985PubMedCrossRefGoogle Scholar