Summary

Less chondral damage correlates with improved survival after Meniscus Transplantation. Osteotomy is not detrimental to survivorship.

Abstract

Introduction

Meniscal allograft transplantation (MAT) is indicated to relieve pain and improve function and hopefully to delay the onset of osteoarthritis in patients with meniscus deficiency. It is not know which factors most affect survivorship of MAT.

Aim

The purpose of this study was to assess the effect of perioperative cartilage status and a concomitant tibial osteotomy on the survivorship of MAT. A secondary analysis evaluated the clinical outcomes in these groups.

Methods

We reviewed a consecutive series of 45 MATs in 42 patients with a minimum follow up of four years. Patients were divided into two groups using the Outerbridge Cartilage Score (OCS); Group 1 (OCS Grades 0-2) and Group 2 (OCS Grades 3-4). Pre- and post-operative outcome scores were collected using the Lysholm, Tegner, Oxford Knee Score and International Knee Documentation Committee subjective knee form. Survival end points were transplant removal and knee arthroplasty.

Results

The mean post-surgical follow-up for patients in group 1 (n=14, age 32.0 +/- 9.8) and group 2 (n=31, age 36.2 +/- 10) was 10.6 years (SD +/-3.35) and 7.1 (SD+/-3.34) respectively. Patients in group 1 demonstrated no failures of the MAT over the time frame evaluated. Patients in Group 2 (n=31) had a 74.2% survival of the MAT. The clinical outcomes improved in all groups with no significant difference between groups. Patients who had had an osteotomy showed no difference in survival (Mantel-cox test p-value of 0.922) and clinical outcomes.

Conclusions

– Patient with minimal cartilage status have improved MAT survivorship but both groups benefit clinically. Tibial osteotomy, when indicated, does not change the outcome of MAT at a minimum of 4 years.