Summary

Obesity increases meniscal allograft transplant failure rates.

Abstract

Purpose

to analyze the effect of obesity and other clinical factors on the outcome of meniscal allograft transplantation (MAT) with transosseous fixation.

Methods

a retrospective cohort study was carried out. Patients who had undergone MAT were included. The variables assessed were: age at the time of the transplant, side, gender, transplanted meniscus (lateral / medial), body mass index (BMI), smoking status and previous surgeries. Lysholm, Tegner and IKDC test outcomes, and patient satisfaction were recorded. Image assessment was carried out using plain standing X-Rays and MRI.

Results

34 patients fulfilled the inclusion criteria. The mean follow-up time was of 73.1 SD 45 months. Patients with a BMI > 30 underwent more frequently medial meniscal transplants (88.9 %; p=0.047). Obese patients had a significantly lower IKDC (48.6 SD 19.9 vs. 62.2 SD 13.0, p= 0.044, power: 47.5%) and Lysholm (60.3 Sd 19.2 vs. 80.0 SD 13.0, p= 0.002, power: 91.3%) scores compared with non-obese patients. The satisfaction and Tegner scores were also lower in obese patients (55.6 % vs 80.0, p=0.201, and 2.8 SD 1.0 vs. 3.8 SD 1.9, p=0.151, respectively); however, these differences were not statistically significant. Obese patients had higher rates of meniscal transplant failure compared to non-obese patients (adjusted hazard ratio 5.4, CI 95% 1.1-29.1, p). No differences were observed between obese and non-obese patients regarding age, gender, side, smoking status, and follow-up time

Conclusions

A BMI > 30 kg/m2 is associated with a higher risk of MAT failure. Moreover, better knee functional results in non-obese patients compared to obese individuals following a MAT were found.
Level of evidence: III. Retrospective cohort study.