Summary: Lateral MAT without graft extrusion led to an improved biochemical composition of the knee articular cartilage, whereas MAT with graft extrusion did not, on midterm follow-up.

Background

Several studies reported that graft extrusion after meniscal allograft transplantation (MAT) is associated with deterioration of surgical outcomes. However, no study has investigated the effect of graft extrusion on the articular cartilage using objective quantitative methods.

Hypothesis/Purpose: This study aims to investigate the influence of graft extrusion on the chondroprotective effect of lateral MAT on knee articular cartilage. We hypothesized that MAT without graft extrusion would result in better cartilage quality than that of MAT with graft extrusion.

Methods

Altogether, 105 patients who underwent isolated lateral MAT were divided into the extrusion and non-extrusion groups based on postoperative 3-month magnetic resonance imaging (MRI). Quantitative T2 mapping was performed on preoperative and postoperative MRI at midterm follow-up (3.2 ± 0.7 years). The weightbearing area of femoral and tibial plateau articular cartilage was divided into six segments (F1, F2, F3, TP1, TP2, and TP3) from anterior to posterior direction according to the meniscal coverage area. Each segment was further segmented into superficial and deep layers for zonal analysis. Longitudinal change in cartilage T2 value was compared between two groups. The Lysholm scores were used to evaluate clinical function.

Results

The mean T2 value of the non-extrusion group showed a significant improvement in 14 out of 18 segments after lateral MAT, whereas the extrusion group showed no statistically significant change. The cartilage biochemical composition showed an improving trend in the non-extrusion group compared to that in the extrusion group, in the F2, TP2, and TP3 segments overall, deep layers of F1, F2, and TP2 segments, and the superficial layer of TP3 segment (P < .05).

Conclusion

Lateral MAT without graft extrusion led to an improved biochemical composition of the knee articular cartilage, whereas MAT with graft extrusion did not, on midterm follow-up.
Clinical relevance: The results of this study would reinforce the importance of avoiding graft extrusion while performing MAT.

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Non-Extruded Grafts Result in Better Cartilage Quality after Lateral Meniscal Allograft Transplantation: Quantitative 3-T MRI T2 Mapping

Non-Extruded Grafts Result in Better Cartilage Quality after Lateral Meniscal Allograft Transplantation: Quantitative 3-T MRI T2 Mapping

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Non-Extruded Grafts Result in Better Cartilage Quality after Lateral Meniscal Allograft Transplantation: Quantitative 3-T MRI T2 Mapping

Non-Extruded Grafts Result in Better Cartilage Quality after Lateral Meniscal Allograft Transplantation: Quantitative 3-T MRI T2 Mapping

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Methods

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