‘Encouraging’ intermediate results seen with meniscal allograft transplantation

Issue: May 2011

SAN FRANCISCO — A minimum 7-year follow-up revealed a high mean satisfaction score among patients who underwent meniscal allograft transplantation.

Brian J. Cole, MD, MBA, presented his group’s findings at the 2011 Annual Meeting of the Arthroscopy Association of North America.

Cole also reported that the procedure could reduce pain, increase range of motion and improve joint function in the long term.

Retrospective review

Brian J. Cole

Cole and his colleagues retrospectively reviewed prospectively collected data on patients who were meniscus deficient and underwent meniscal allograft transplantation at a single center between Nov. 1997 and July 2002. The patients had a minimum follow-up of 7 years.

The investigators compared preoperative subjective data and findings from physical examinations to follow-up findings. They assessed bone plug/bridge healing and joint space integrity through radiographic evaluation when images were available. They also evaluated patients using SF-12 physical and mental, Lysholm, IKDC and KOOS scores. Patients were also asked to rate their overall satisfaction with the procedure and relate whether they would undergo the surgery on their contralateral knee given similar circumstances.

Improved scores

In all, 22 patients with a mean follow-up of 8.49 years were included in the study. The cohort showed statistically significant improvements in postoperative subjective scores, with a mean postoperative satisfaction rate of 8.8 out of 10. Furthermore, nearly 91% of patients asserted they would, given similar circumstances, undergo the surgery on their contralateral knee. Investigators also found that the patients sustained measured improvements through 2-, 4-, and 7-year postoperative follow-ups.

Meniscal allograft transplantation improved upon preoperative scores whether the procedure was performed concomitantly or in isolation. A comparison of patients over a body mass index of 25kg/m² with those under that mark showed no differences in outcomes. Minimal patellofemoral joint tenderness and effusion were found on follow-up, Cole reported, and patients displayed a near-normal range of motion. Radiographic evaluations, he added, displayed successful bony integration of the bone plugs/bridge from the allograft meniscus.

Though the results were “encouraging,” Cole said further research is necessary to understand the efficacy of allograft meniscus transplantation in preventing the advance of osteoarthritis and maintaining higher levels of function.

“Certainly we can improve this study with a larger cohort, and we are doing that as we speak,” Cole concluded. “Combined vs. isolated procedures really have to be looked at as a breakout to give us a little more insight into why patients are achieving benefits. Obviously, we want to continue to achieve longer follow-up to see when these things will finally break down and fail, because ultimately they will do so.”

Reference:
Cole BJ, et al. Prospective long-term evaluation of allograft meniscus transplantation: A minimum 7-year follow-up. Paper SS-33. Presented at the 2011 Annual Meeting of the Arthroscopy Association of North America. April 14-16. San Francisco.
Disclosures: Cole receives royalties from Arthrex, Inc., DJ Orthopaedics, Lippincott, WB Saunders and Elsevier; is a member of the speakers bureau or performs paid presentations for Genzyme; is a paid consultant for Zimmer, Arthrex, Inc., Carticept, Biomimmetic, Allosource and DePuy; receives research support from Regentis, Arthrex, DJ Ortho and Smith & Nephew; and is an editorial or governing board member for JBJS, AJSM, Cartilage, JSES, AJO and Elsevier.

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