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Long-term study finds 15% survivorship of meniscal allograft transplantation at 24 years
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LAS VEGAS — A retrospective study of 313 patients with 329 meniscal allograft transplantations performed at Ghent University Hospital in Belgium showed overall cumulative 24-year allograft survivorship of 15% when removal of the allograft by conversion to total knee arthroplasty or total meniscectomy was used as an endpoint.
“We think there is only a limited indication for meniscal allograft transplantation as a surgical option for meniscectomy in symptomatic patients younger than 35 with no to mild cartilage damage,” Catherine Van Der Straeten, MD, said during her presentation here at the American Academy of Orthopaedic Surgeons Annual Meeting.
Patients had a mean age of 33 years at the time of meniscal allograft transplantation, and 44% of them had no to mild meniscal damage and 42% had moderate to severe cartilage damage. In addition, 35% of patients underwent concomitant procedures at the time of transplantation, such as microfracture, osteotomy or ACL reconstruction.
At a mean follow-up of 6.8 years, 90 meniscal allografts were removed for clinical symptoms or progression of osteoarthritis. Five patients died and 48 were lost to follow-up, Van Der Straeten said.
The researchers found 186 menisci were still in situ, but 17 menisci had undergone partial meniscectomy; 35 menisci were torn or re-torn after suture; two showed evidence of resorption on MRI; and 132 were intact without a tear and partially visible on MRI. Of the 90 removed meniscal allografts, 48 of them were converted to total knee arthroplasty; 15 were converted to a unicompartmental knee arthroplasty; and 27 resulted in a total meniscectomy.
The study also showed that age at surgery was a factor for meniscal allograft survivorship, with patients older than 35 years at the time of surgery having an odds ratio of 2.2 for worse survivorship. Cartilage damage at the time of surgery showed an odds ratio of 2.9 for having worse survivorship, and concomitant osteotomy was also significantly linked with worse survivorship. – by Gina Brockenbrough, MA
Reference: Van Der Straeten C, et al. Paper #252. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2015; Las Vegas.
Disclosure: Van Der Straeten reports no relevant financial disclosures.