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Meniscal allograft transplantation combined with anterior cruciate ligament reconstruction provides good mid-term clinical outcome

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Aim of this study is to document if combined meniscal allograft transplantation (MAT) and ACL reconstruction can improve knee function, reduce pain and allow patients with meniscal defect and ACL lesion to resume sport activities.

Methods

Fifty MAT, arthroscopically performed without bone plugs and combined with one-stage primary or revision ACL reconstruction, with or without high tibial osteotomy (HTO), were included. Patients (aged 38.2 ± 10.6 years, 87% males) were evaluated at a mean follow-up of 5 years with Lysholm, Tegner and VAS scores. Patient satisfaction was also recorded, together with complications and failures.

Results

VAS and Lysholm scores improved significantly (from 63.7 to 24.5 and from 60.6 to 82.7, respectively, p < 0.001), while the Tegner score did not reach pre-injury values (p < 0.001), but it improved significantly compared to pre-surgery values (from 2.8 to 4.6, p < 0.001). Medial MAT reported significantly better results compared to lateral MAT. Patients undergoing concomitant HTO reported a significantly higher decrease of VAS. Younger patients with higher pre-operative pain and lower activity level presented higher satisfaction. Eight patients needed a reoperation. Three patients were considered surgical failures while four were considered clinical failures, for a total of 15% failures.

Conclusions

Meniscal allograft transplantation combined with ACL reconstruction represents a safe and suitable treatment, which should be considered as a suitable option in the clinical practice. All evaluated patient profiles, ACL injury in a patient with post-meniscectomy syndrome, failed ACL reconstruction in patients with a meniscus defect, and ACL reconstruction in patients with malalignment due to meniscal defect, benefited from the combined MAT procedure at medium-term follow-up.

Level of evidence

IV.

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for- profit sectors.

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Authors and Affiliations

  1. II Clinica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Stefano Zaffagnini & Alberto Grassi

  2. Laboratorio NABI, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Iacopo Romandini & Giuseppe Filardo

  3. Department of Biomedical Sciences, Knee Joint Reconstruction Center, 3rd Orthopaedic Division, Humanitas Clinical Institute, Humanitas University, Milan, Italy

    Maurilio Marcacci

Authors
  1. Stefano Zaffagnini
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  2. Alberto Grassi
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  3. Iacopo Romandini
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  4. Maurilio Marcacci
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  5. Giuseppe Filardo
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Corresponding author

Correspondence to Iacopo Romandini.

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Conflict of interest

Stefano Zaffagnini, Alberto Grassi, Iacopo Romandini, Maurilio Marcacci, Giuseppe Filardo declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. For this type of study formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Zaffagnini, S., Grassi, A., Romandini, I. et al. Meniscal allograft transplantation combined with anterior cruciate ligament reconstruction provides good mid-term clinical outcome. Knee Surg Sports Traumatol Arthrosc 27, 1914–1923 (2019). https://doi.org/10.1007/s00167-018-5078-0

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  • DOI: https://doi.org/10.1007/s00167-018-5078-0

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