2015 ISAKOS Biennial Congress ePoster #1612
An Osteophyte in the Tibial Plateau is a Risk Factor for Allograft Extrusion After Meniscus Allograft Transplantation
Seong-Il Bin, MD, PhD, Seoul KOREA, REPUBLIC OF
Byeong-Sam Jeon, MD, Seoul KOREA, REPUBLIC OF
Jong-Min Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Chang-Rack Lee, MD, Seoul KOREA, REPUBLIC OF
Dept. of Orthopaedic Surgery, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, KOREA
FDA Status Not Applicable
Summary: The excision of a peripheral osteophyte larger than 2 mm in the proximal tibial plateau was associated with allograft extrusion after MAT.
Osteophytes may be observed on the tibial plateau during meniscal allograft transplantation. However, no studies to date have evaluated the effect of these osteophytes on meniscal allograft extrusion
Osteophyte excision in the tibial plateau could reduce extrusion of the transplanted meniscus and improve short-term clinical outcomes with meniscus allograft transplantation.
Between October 2005 and July 2012, 323 patients underwent MAT in our institution. Of these, 88 patients had a peripheral osteophyte in their tibial plateau and were enrolled in the study, retrospectively. The mean age of the patients was 35.3 years (range, 15–56 years). Fifty-seven patients were male and 31 female. Forty-four patients underwent osteophyte excision concomitantly with MAT and 44 patients underwent MAT only. The two groups showed no difference in terms of age, body mass index, the time after meniscectomy, and preoperative knee scores. A medial meniscus allograft was transplanted in 13 cases (15%) and a lateral meniscus in 75 (85%). The absolute extrusion (AE) and relative percentage of extrusion (RPE) were measured to evaluate allograft extrusion 12 months after MAT. The modified Lysholm scoring system27 and the Hospital for Special Surgery (HSS) score at 1 year after MAT were used to evaluate clinical outcomes.
The mean AEs at postoperative 1 year in the excision and nonexcision groups were 3.5 ± 1.5 and 5.5 ± 1.6 mm, respectively. The mean RPEs were 34.1 ± 15.9% and 54.7 ± 20.7%, respectively. The rate of allograft extrusion (greater than 3 mm) was 28/44 (63.6%) and 41/44 (93.2%) in the excision and nonexcision groups, respectively. The intergroup differences in AE, RPE, and rate of allograft extrusion were statistically significant (p < 0.001 for all three parameters). There were no significant differences in the clinical outcomes (modified Lysholm score, Hospital of Special Surgery score) and joint space width (JSW) at 1 year follow up (p < 0.662, p < 0.433, and p < 0.523, respectively).
The excision of a peripheral osteophyte larger than 2 mm in the proximal tibial plateau was associated with allograft extrusion after MAT.
Level of evidence: Level III, Retrospective comparative study