Summary

Autologous semitendinosus tendon could potentially be an option for meniscus substitution in selected cases.

Abstract

Introduction

Meniscectomy result in poor knee function and increased risk for osteoarthritis. Meniscal allograft transplantation is not widely used due to costs and availability. The semitendinosus tendon (ST) has the potential to remodel and revascularize in an intraarticular environment such as ACL reconstruction. The objective for this pilot study was to investigate whether the ST graft could function as a meniscal transplant.

Material And Methods

The ST was doubled and sutured with running sutures and pull-out sutures in each end. Bone tunnels were used for root anchorage and the graft was sutured with all-inside, inside-out and outside-in technique. The pull-out sutures were fixed over a button. Partial weight bearing was allowed with limited range of motion in a brace for the first six weeks. Evaluation was assessed using clinical examination, radiology and patient reported outcome.

Results

A total of seven patients have been included between January 2018 and June 2020. Six medial transplants and one lateral transplant were performed. Mean age was 29 years. Four patients had completed the 12-month follow-up. Improvements were noted for IKDC Global Score (p=0.004), KOOS pain subscale (p=0.038) and Lysholm (p=0.005). MRI indicate that the transplant become more wedge-like with visible roots and minor protrusion. The results will be updated accordingly before the presentation.

Conclusion

Even though this is primarily a technical report the follow-up data indicate that the transplant survives and adapts in shape and capabilities to an original meniscus. There were no adverse events and the patients seem to improve in terms of pain and quality of life.