Meniscal allograft transplantation may improve knee function

1. Through a systematic review of 55 studies examining meniscal allograft transplantation, clinical improvement in knee function was demonstrated following surgery in all studies. 

2. Among all studies, the overall complication rate was 12.2% and rate of MAT failure was 8.7%. 

Evidence Rating Level: 3 (Average)                                  

Study Rundown: Meniscal allograft transplantation (MAT) is often performed following meniscectomy in order to better stabilize and support the knee joint and ultimately delay the onset of osteoarthritis. As a relatively new operation, many of its features are widely contested. The authors of this study systematically reviewed the current literature on MAT in order to better characterize its indications, methods, and outcomes. The authors found consensus among all studies for performing MAT in young and middle-aged individuals with a well-aligned, stable, non-arthrotic knee with joint line pain from previous meniscectomy. They noted improvement in clinical outcomes across all studies and acceptable rate of complication/failure rate suggest the efficacy of the procedure. The generalizability of these results are limited by differences across studies such as surgical technique, co-occurring procedures, and variability in outcome measurements. Further limitations include the retrospective nature of most included studies and potential overlap of data sets.

Click to read the study in the American Journal of Sports Medicine

Relevant Reading: Meniscal allograft transplantation–part I: background, results, graft selection and preservation, and surgical considerations.

Meniscal allograft transplantation–part II: alternative treatments, effects on articular cartilage, and future directions

In-Depth [systematic review]: 55 peer-reviewed studies on meniscal allograft transplantation were analyzed in this study.  Publications were included if they had 10 or more patients, an 80% 12 month follow-up rate, and documentation of clinical or radiological outcomes following combined or isolated MAT in the knee. Two studies were classified as level 1, seven as level 3 and forty-six as level 4. The review found consensus with regards to the indications for surgery. Frozen and cryopreserved grafts were the most commonly used and both showed similar efficacies.  All studies found an improvement in clinical outcomes from pre-operation to last follow-up, which was most frequently assessed with Lysholm, Tegner, and VAS pain scores. No studies found significant differences in clinical outcomes between those undergoing MAT alone or in combination with other procedures; however the overall complication rate for MAT done either alone or in combination (12.2%) was higher than the rate observed for MAT alone (3.6%). The rate of MAT failure was 8.7% among all included studies.

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Image: PD 

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