Isolated meniscal allografting may be effective following lateral meniscectomy

Most subjective and clinical measures showed no significant differences between fixation methods, but bony fixation may provide better postop function.

Isolated meniscal allograft transplantation may benefit certain patients with lateral meniscus-deficient knees, a retrospective study suggests.

Jon K. Sekiya, MD, MC, USNR, and colleagues in Pennsylvania and Virginia reviewed clinical outcomes of isolated lateral meniscal allograft transplantation in 25 patients previously treated with lateral meniscectomy and who completed subjective follow-up evaluations. Of these, 17 patients also had complete follow-up radiographs.

Preoperatively, most patients had grade 2 chondrosis and only small areas of less than 1 cm2 grade 3 or 4 chondrosis. “All patients described persistent joint line or compartmental pain during activities of daily living and/or sports, had failed a trial of conservative therapy, and thus were considered good candidates for meniscal allograft transplantation,” the authors said in the study, published in the journal Arthroscopy.

Surgeons used bony fixation for 17 patients and suture fixation of the anterior and posterior meniscal allograft horns for 8 patients. At latest follow-up, 96% of patients stated they believed their overall function and activity level had improved. Additionally, patients had higher physical and mental component summary scores of the Short Form-36 compared to scores for age- and sex-matched patients in the general U.S. population, according to the study.

The researchers found no significant differences in Lysholm scores, activities of daily living, Sports Activity Scale or overall self-rating between patients treated with either fixation method. “Overall, 13 patients stated that they were ‘greatly better,’ 7 were ‘somewhat better,’ 4 were ‘slightly better,’ and 1 patient reported a ‘somewhat worse’ condition as a result of surgery,” the authors said.

However, some clinical differences were noted between fixation methods. “A significant difference was observed between suture and bony fixation ... with regard to loss of passive knee extension, with the bony fixation group having getter extension compared with the suture fixation group (P=.03),” the authors said.

Patients in the bony fixation group also had a significantly better overall International Knee Documentation Committee (IKDC) rating for range of motion (P=.01), although there was no difference in IKDC laxity or other clinical measures of function, they noted.

For more information:
Sekiya JK, West RV, Groff YJ, et al. Clinical outcomes following isolated lateral meniscal allograft transplantation. Arthroscopy. 2006;22:771-780.