Summary: This study assessed the long-term outcomes of meniscus allografts in patients older than 50 years of age and found that meniscus transplants in combination with other arthroscopic knee treatments delay knee arthroplasty, improve knee symptoms of pain and improve function in a population over 50 years who are otherwise candidates for knee arthroplasty.

Introduction

Although progression from meniscus injury to knee arthroplasty is complex, a critical stage exists between 50 and 70 years of age. One topic of investigation often overlooked is the utility of meniscus allografts in combination with other arthroscopic procedures to delay knee arthroplasty for patients in this age range. The purpuse of this study was to assess the ability of meniscus allografts in combination with other procedures to delay knee arthroplasty in patients older than 50 years of age.

Methods

108 meniscus allograft transplants (MATs) using the arthroscopic three tunnel technique between 1997 and 2019 in patients over 50 years of age and told to have a knee arthroplasty were reviewed. Patient ages ranged from 50 to 69 years of age (mean 55.8). 86 of 108 (79%) patients met eligibility for this case series report. Inclusion criteria were patients told to consider a knee arthroplasty with pain in a meniscectomized compartment with preservation of some joint space by standing AP and PA flexion x-ray. Exclusion criteria was defined as failure to comply with rehabilitation protocol or failure to complete baseline and follow-up research questionnaires. 74 of 86 (86%) patients had Grade III or IV arthritis documented by Outerbridge findings on X-ray and direct observation. 44 of 86 (51%) patients underwent concomitant cartilage repair with the articular cartilage paste graft technique previously reported. International Knee Documentation Committee (IKDC) and Visual Analogue Pain Scale (VAS) were obtained longitudinally throughout the post-operative period. Time from meniscus transplantation to knee arthroplasty was measured with failure of the surgical procedure defined as progression to arthroplasty, no improvement in pain scores, or increased pain.

Results

Over the follow-up range of 2 to 25 years, 41 of 86 (47.6%) patients progressed to revision by arthroplasty, at a mean time of 8.5 years. 68 of 89 (76%) meniscus transplants in patients over 50 delayed joint arthroplasty by a minimum of 8.2 years (8.2-20.6). At the time of reporting, 41 of 86 (47.6%) patients had intact meniscus transplants. Significant improvements (p<0.05) were observed in both pain and function as assessed by VAS and IKDC. These significant improvements were sustained through ten years post-operatively, correlated to a mean age of 65.8 years of age.

Discussion

Meniscus allografts in combination with other arthroscopic knee treatments delay knee arthroplasty, improve knee symptoms of pain and improve function in a population over 50 years who are otherwise candidates for knee arthroplasty. The individual contribution of the meniscus separate from the concomitant procedures cannot be defined.

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Do All Meniscal Ramp Lesions Require Repair? A Prospective Study Of Ramp Lesions with Concomitant ACL Injury? ePoster Presentation Silvampatti Ramasamy Sundararajan, MS(Orth), INDIA Meet Mehta, MD orthopaedics, INDIA Terence Dsouza, MS, DNB, FNB, INDIA Ramakanth Rajagopalakrishnan, D.ortho, DNB(ortho).D.SICOT, INDIA S Rajasekaran, MS(Orth),DOrth,DNB,FRCS(Ed),FRCS(Lon),MCh(Liv),PhD, INDIA
Bidirectional Evaluation for the Lateral Meniscal Extrusion After Repairing Isolated Longitudinal Tear ePoster Presentation Akira Tsujii, MD, PhD, JAPAN Seira Sato, MD, PhD, JAPAN Tomoki Ohori, MD, PhD, JAPAN Tatsuo Mae, MD, PhD, JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Yasukazu Yonetani, MD, PhD, JAPAN Masayuki Hamada, MD, JAPAN Ken Nakata, MD, PhD, JAPAN
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Evolution in the Indication of Surgical Treatment on Degenerative Meniscal Tears In the Last 20 Years ePoster Presentation Alejandro Espejo-Reina, MD, MSc, SPAIN Enrique Sevillano-Perez, MD, SPAIN María Josea Espejo-Reina, MD, SPAIN Maximiano Lombardo-Torre, SPAIN Miguel Verdejo-Parrilla, MD, MSc, SPAIN Alejandro Espejo-Baena, MD, SPAIN
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Biomechanical Comparison Of Novel Meniscus Cap Repair Technique With Simple Meniscus Suture And Collagen Matrix Meniscus Suture Techniques For Complex Tears Of The Medial Meniscus ePoster Presentation Kinga Ciemniewska-Gorzela, PhD, POLAND
The Hidden Lesion of the Knee: Risk Factors Study ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Anis Tebourbi, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Rami Triki, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
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Determinants of Radiologic and Functional Outcomes after Meniscal Repair of Longitudinal Vertical Tears. A Prospective Cohort Study of 78 patients. ePoster Presentation Benjamin Tschopp, MD, SWITZERLAND Robin Martin, MD, SWITZERLAND
Meniscal Repair Is A Solution In “Older” Patients: A Systematic Literature Review with Meta-Analysis ePoster Presentation Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, CANADA Chris Saunders, PhD MBChB BMedSci (Hons), UNITED KINGDOM Matthew Sedgwick, Ph.D., UNITED KINGDOM
Associated Fracture of Spinal Tuberosity with Anterior Root Injury of Lateral Meniscus ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Rami Triki, TUNISIA Mohamed Hedi Ezzine, MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
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Virtual Reality Simulation is Valuable for Arthroscopic Diagnosis and Meniscectomy: A Transfer Validity Study of 36 Residents ePoster Presentation Alexandre Tronchot, MD PhD, FRANCE Tiphaine Casy, PhD, FRANCE Nicolas Vallee, MD, FRANCE Harold Common, MD, FRANCE Hervé Thomazeau, PR, FRANCE Pierre Jannin, PhD, FRANCE Arnaud Huaulme, PhD, FRANCE
Clinical Result of the Two Stage ACL Reconstruction and Meniscus Allograft Transplantation, Is It Comparable To The Meniscus Allograft Transplantation Alone? ePoster Presentation S. Ali Ghasemi, MD, UNITED STATES Shervin Rashidinia, MD, IRAN, ISLAMIC REPUBLIC OF Adel Mahjoub, MD, UNITED STATES Lawrence S. Miller, UNITED STATES
Strength-Based Rehabilitation On Clinical Outcomes In Patients Post-Meniscectomy: A Systematic Review and Meta-Analysis ePoster Presentation Prushoth Vivekanantha, BMSc, CANADA Yi (David) Diao, BMSc, CANADA Dan Cohen, MD, CANADA Ben Murphy, DPT, CANADA Darren L. de SA, MBA(c), MD FRCSC, CANADA
Meniscal Ramp Lesion, A Contact Characteristic Analysis In Cadaver ePoster Presentation Artit Boonrod, MD, THAILAND Khananut Jaruwanneechai, MD, THAILAND Sermsak Sumanont, MD, THAILAND Nadhaporn Saengpetch, THAILAND
Arthroscopic Treatment of Meniscal Cysts and Clinical Follow Up ePoster Presentation Sang Hak Lee, MD, PhD, KOREA, REPUBLIC OF Tae Wook Kim, MD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF Jun Bum Park, MD, KOREA, REPUBLIC OF Min-Gyu Kim, MD, KOREA, REPUBLIC OF
Knee Cartilage and Meniscus in Recreational marathon runners: a MRI T2 * mapping investigation ePoster Presentation Siyu Dai, PhD, CHINA Feng Chen, PhD, CHINA Dingbo Shu, MD, CHINA Fanjing Meng, MD, CHINA Le Wang, MD, CHINA Yanjing Zhang, MD, CHINA Jianping Ding, MD, CHINA
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Etiology of Posterior Meniscus Root Tears: Medial vs. Lateral ePoster Presentation Katrin Karpinski, MD, GERMANY Philipp Forkel, MD, GERMANY Martin Häner, MD, GERMANY Wolf Petersen, MD, Prof, GERMANY
Comparison Of Resultant Force Through The Repaired Lateral Meniscus With Between Inside-Out And All-Inside-Suture Techniques ePoster Presentation Takehito Hirose, MD, PhD, JAPAN Tatsuo Mae, MD, PhD, JAPAN Satoshi Yamakawa, PhD, JAPAN Issei Ogasawara, PhD, JAPAN Shoji Konda, PhD, JAPAN Yasuhiro Take, MD, PhD, JAPAN Ken Nakata, MD, PhD, JAPAN
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Predictors of The Ten-Year Patient-Reported Outcome Measures After Collagen Meniscus Implant (CMI) For Partial Meniscus Deficiency ePoster Presentation Alberto Grassi, PhD, ITALY Gian Andrea Lucidi, MD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Giacomo Dal Fabbro, ITALY Nicola Pizza, MD, ITALY Marianna Viotto, ITALY Luca Ambrosini, MD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
Concomitant Medial Meniscal Ramp Lesions and Lateral Meniscal Tears with Anterior Cruciate Ligament Injuries are Associated with Anterior Tibial Subluxation in Knee Extension ePoster Presentation Hibiki Kakiage, MD, JAPAN Kazuhisa Hatayama, MD, PhD, JAPAN Satoshi Nonaka, MD, JAPAN Masanori Terauchi, MD, JAPAN Atsufumi Oshima, MD, JAPAN HIrotaka Chikuda, MD, PhD, JAPAN
Good Clinical Results After Combined Arthroscopic Meniscal Allograft Transplantation and Autologous Chondrocyte Implantation Using Chondrospheres ePoster Presentation Rainer Siebold, Prof. Dr. med., GERMANY Johannes Pawelczyk, cand. med., GERMANY
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A New Arthroscopic Pull-In All-Suture Anchor Meniscus Root Tear Repair Shows Comparable Biomechanical Properties as Conventional Trans-Osseous Pull-Out and Anchor Repair ePoster Presentation Thorben Briese, MD, GERMANY Amaris Kieninger, MD, GERMANY Elmar Herbst, MD, PhD, GERMANY Johannes Glasbrenner, MD, GERMANY Christian Peez, MD, GERMANY Adrian Deichsel, MD, GERMANY Maurice Balke, MD, GERMANY Jens Wermers, MD, GERMANY Matthias Klimek, M. Sc., GERMANY Michael J. Raschke, MD, Prof., GERMANY Christoph Kittl, MD, MD(res), GERMANY
Large Posterolateral Cartilage Slope Is a Risk Factor for Noncontact ACL Injury ePoster Presentation Kensuke Hotta, MD, JAPAN Mitsuru Hanada, MD, PhD, JAPAN Kazuki Nomoto, MD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
No Dynamic Extrusion of the Medial Meniscus in Ultrasound Examination in Patients with Confirmed Root Tear Lesion ePoster Presentation Katrin Karpinski, MD, GERMANY Theresa Diermeier, MD, GERMANY Lukas Willinger, MD, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Andrea E. Achtnich, Assoc. Prof., GERMANY Wolf Petersen, MD, Prof, GERMANY
Clinical Characteristics Of Isolated Meniscal Tears During Sports Activities Among Young Athletes ePoster Presentation Yuta Tachibana, M.D., Ph.D., JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Hiroshi Amano, MD, PhD, JAPAN Keisuke Kita, MD, PhD, JAPAN Yasukazu Yonetani, MD, PhD, JAPAN Shuji Horibe, MD, PhD, JAPAN Yoshinari Tanaka, MD, PhD, JAPAN
Good Clinical Results And Patient Satisfaction After Arthroscopic Repair of Large Meniscus Bucket Handle Tears of the Knee ePoster Presentation Johannes Pawelczyk, cand. med., GERMANY Rainer Siebold, Prof. Dr. med., GERMANY
The High Prevalence of Spin Reporting Bias in Meniscal Allograft Transplant Abstracts: A Qualitative Assessment Of Systematic Reviews and Meta-Analyses ePoster Presentation Matthew T Gulbrandsen, MD, UNITED STATES Mustafa Hashimi, BS, UNITED STATES Taha Taka, BS, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Anthony Essilfie, MD, UNITED STATES Anikar Chhabra, MD, MS, UNITED STATES Seth L. Sherman, MD, UNITED STATES
Popliteomeniscal Fascicles Tears with Lateral Meniscus Instability: Outcomes of Arthroscopic Surgical Technique at Mid-Term Follow-Up ePoster Presentation Simone Cerciello, MD, ITALY Gianluca Ciolli, MD, ITALY Fabrizio Mocini, MD, ITALY Dario Candura, ITALY Lorenzo Proietti, MD, ITALY Roberto Simonetta, ITALY Katia Corona, MD, ITALY Gianni Di Vico, MD, ITALY
Biomechanics Comparison Between Transtibial Pullout, Suture Anchor And All-Suture Anchor Technique For Posterior Medial Meniscal Repair ePoster Presentation Nadhaporn Saengpetch, THAILAND Napat Prasitmeeboon, MD, THAILAND Tanapol Janyawongchot, MD, THAILAND Sorawut Thamyongkit , MD, THAILAND
Can Local Anesthesia be Considered as Gold Standard in Knee Arthroscopy? ePoster Presentation Tilemachos Papageorgiou, MD, GREECE Stefanos Christos Papageorgiou, MD, GREECE ILIAS SOTIRIADIS, MD, GREECE Tsoumanis Dimitrios, MD, GREECE Christos D. Papageorgiou, MD, PhD, GREECE
Evolution in the Indication of Surgical Treatment on Repairable Meniscal Tears and Their Treatment in the Last 20 Years ePoster Presentation Alejandro Espejo-Reina, MD, MSc, SPAIN Enrique Sevillano-Perez, MD, SPAIN María Josea Espejo-Reina, MD, SPAIN Maximiano Lombardo-Torre, SPAIN Miguel Verdejo-Parrilla, MD, MSc, SPAIN Alejandro Espejo-Baena, MD, SPAIN
Clinical Outcomes with Meniscal Repair, Between 2019-2020, Viña del Mar, Chile (Preliminary Study) ePoster Presentation Sergio Patricio González Rouse, MD, MSc, MBA, CHILE Raul Roz, MD, CHILE Horacio Alejandro Carvajal Araya, MD, CHILE
Posterior Cruciate Buckling Angle Variations are Associated With Different Patterns of Medial Meniscus Tears in Anterior Cruciate Deficient Knees: Results of a Prospective Comparative Magnetic Imaging Resonance Study ePoster Presentation Simone Cerciello, MD, ITALY Gianluca Ciolli, MD, ITALY Dario Candura, ITALY Michele Mercurio, MD, ITALY Fabrizio Mocini, MD, ITALY Lorenzo Proietti, MD, ITALY
New Conservative Treatment Option for Symptomatic Degenerative Medial Meniscus Tear -Ultrasound-Guided Injection of MCL Bursa- ePoster Presentation Junsuke Nakase, MD, PhD, JAPAN Rikuto Yoshimizu, JAPAN Tomoyuki Kanayama, MD, JAPAN Yusuke Yanatori, MD, JAPAN Hiroyuki Tsuchiya, JAPAN
Bone Bridge Technique For Lateral Meniscal Allograft Transplantation – No Difference In Clinical Outcome Compared To The Soft Tissue Technique ePoster Presentation Rahul Bhattacharyya, MBCHB (Hons), MD (Res), FRCS (Orth), MSc, MRCS, UNITED KINGDOM Harry Krishnan, FRCS(Tr&Orth),MEd(ULT), MBBS, BSc (Hons), UNITED KINGDOM Nicole Bausch, MSc physiotherapy and education, UNITED KINGDOM Adam Richard Pilarski, MBBS, MRCS, MBA, BA (hons), UNITED KINGDOM Niall McGoldrick, MB MCh FRCS (Tr & Orth), IRELAND Peter Thompson, MBChB, UNITED KINGDOM Andrew Metcalfe, PhD, UNITED KINGDOM Tim Spalding, FRCS(Orth), UNITED KINGDOM
Increased Mechanical Axis Malalignment Does Not Lead to Worse Outcomes Following Transtibial Meniscus Root Repair ePoster Presentation Logan M. Good, BS, UNITED STATES Reid Palumbo, BS, UNITED STATES Parker Cavendish, BS, UNITED STATES Eric Milliron, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES James C. Kirven, BS, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES
Medial Meniscus Repair only Partially Restores In-Vivo Knee Kinematics after ACL Reconstruction ePoster Presentation Alberto Grassi, PhD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Gian Andrea Lucidi, MD, ITALY Erika Pinelli, MsC, ITALY Gregorio Marchiori, MD, ITALY Marco Bontempi, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
Comparing the Risk of Iatrogenic Peroneal Nerve Injury in All-inside Lateral Meniscus Repair between Preoperative and Real Arthroscopic Position MRIs ePoster Presentation Chaiwat Chuaychoosakoon, MD, THAILAND Wachiraphan Parinyakhup, MD, THAILAND Tanarat Boonriong, Principal, THAILAND

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Meniscus Transplants Delay Arthroplasty in Patients Over 50 Years of Age

Meniscus Transplants Delay Arthroplasty in Patients Over 50 Years of Age

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Discussion

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Meniscus Transplants Delay Arthroplasty in Patients Over 50 Years of Age

Meniscus Transplants Delay Arthroplasty in Patients Over 50 Years of Age

Introduction

Methods

Results

Discussion

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