2020 - The results of meniscal allograft transplantation surgery: what is success?

Reference

Searle H, Asopa V, Coleman S, McDermott I. The results of meniscal allograft transplantation surgery: what is success? BMC Musculoskelet Disord. 2020 Mar 12;21(1):159. doi: 10.1186/s12891-020-3165-0. PMID: 32164670; PMCID: PMC7069211.

In this paper the authors collected and looked back over the data of sixty patients (aged between 18 and 50) and who had had a meniscal allograft transplantation (MAT) during the six year study period (2008-2014). They examined the failures and evaluated the overall success...

The authors looked various parameters when assessing failure -

• Surgical failure - removal of graft, revision MAT or conversion to arthroplasty (knee replacement)
• Clinical failure - level of symptoms after the procedure (measured by the Lysholm score)
• Complications - such as secondary tears of the graft itself
• Patient satisfaction - whether or not the patient felt, looking back, that they would still have undergone the procedure

Evaluation was challenged by the fact that the sample size was small, many of the patients had had other procedures done to the same knee at the time of the meniscal allograft, and also only 72% of patients responded to the full questionnaire. Also there were both men and women, in some the surgery was on the medial side and in some the lateral side, and the patients had differing degrees of underlying joint cartilage damage. So it was not easy to be categorical about the outcome.

However, the scoring systems used to assess patient quality of life, sports activity and knee-specific symptoms (KOOS, IKDC, Lysholm) were generally favourable, and even 60% of those patients whose surgery was deemed by the authors to have been a failure stated that they would still have undergone the procedure if they had known their own outcome. On this basis the authors concluded that overall the procedure could be deemed a success.