Mid-Term Clinical and Radiological Outcomes of Lateral Meniscal Allograft Transplantation with Suture-Only Fixation Plus Capsulodesis

Rodolfo Morales-Avalos; Ángel Masferrer-Pino; José Ramón Padilla-Medina; Jorge Amestoy-Ramos; Maximiliano Ibáñez; Simone Perelli; Cristina Ariztegui-Andrade; João Espregueira-Mendes; Joan Carles Monllau

doi:10.1055/a-1946-7079

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2024; 37(01): 026-036
DOI: 10.1055/a-1946-7079

Original Article

Mid-Term Clinical and Radiological Outcomes of Lateral Meniscal Allograft Transplantation with Suture-Only Fixation Plus Capsulodesis

Authors

Rodolfo Morales-Avalos

¹Knee and Arthroscopy Unit, ICATME, Hospital Universitari Dexeus, Universitat Autonoma de Barcelona (U.A.B.), Barcelona, Catalunya, Spain

²Department of Physiology, School of Medicine, Universidad Autonoma de Nuevo León (U.A.N.L.), Monterrey, Nuevo León, México

³Knee Unit, Department of Orthopedic Surgery and Traumatology, University Hospital “Dr. José Eleuterio González,” Universidad Autonoma de Nuevo León (U.A.N.L.), Monterrey, Nuevo León, México
Ángel Masferrer-Pino

¹Knee and Arthroscopy Unit, ICATME, Hospital Universitari Dexeus, Universitat Autonoma de Barcelona (U.A.B.), Barcelona, Catalunya, Spain
José Ramón Padilla-Medina

³Knee Unit, Department of Orthopedic Surgery and Traumatology, University Hospital “Dr. José Eleuterio González,” Universidad Autonoma de Nuevo León (U.A.N.L.), Monterrey, Nuevo León, México
Jorge Amestoy-Ramos

¹Knee and Arthroscopy Unit, ICATME, Hospital Universitari Dexeus, Universitat Autonoma de Barcelona (U.A.B.), Barcelona, Catalunya, Spain
Maximiliano Ibáñez

¹Knee and Arthroscopy Unit, ICATME, Hospital Universitari Dexeus, Universitat Autonoma de Barcelona (U.A.B.), Barcelona, Catalunya, Spain
Simone Perelli

¹Knee and Arthroscopy Unit, ICATME, Hospital Universitari Dexeus, Universitat Autonoma de Barcelona (U.A.B.), Barcelona, Catalunya, Spain

⁴Department of Surgery and Morphologic Science, Orthopaedic Surgery Service, Universitat Autònoma de Barcelona, Hospital del Mar, Barcelona, Catalunya, Spain
Cristina Ariztegui-Andrade

⁵School of Medicine, Universidad Autonoma de Nuevo León (U.A.N.L.), Monterrey, Nuevo León, México
João Espregueira-Mendes

⁶FIFA Medical Centre of Excellence, Clínica do Dragão, Espregueira-Mendes Sports Centre, Porto, Portugal

⁷School of Medicine, Minho University, Braga, Portugal
Joan Carles Monllau

¹Knee and Arthroscopy Unit, ICATME, Hospital Universitari Dexeus, Universitat Autonoma de Barcelona (U.A.B.), Barcelona, Catalunya, Spain

⁴Department of Surgery and Morphologic Science, Orthopaedic Surgery Service, Universitat Autònoma de Barcelona, Hospital del Mar, Barcelona, Catalunya, Spain

Abstract

Meniscal allograft transplantation (MAT) is an effective reconstructive procedure for treating a symptomatic postmeniscectomy syndrome. It consists of replacing the lost meniscal tissue aiming to improve the clinical outcomes and prevent progressive deterioration of the joint. The aim of this study was to evaluate meniscal graft survivorship and report on the radiographic (in terms of graft extrusion and joint space width and alignment) and the functional results through a midterm follow-up of lateral MAT performed with a soft tissue fixation technique after capsulodesis. In total, 23 patients who underwent lateral MAT as a single procedure were included. The Knee injury and Osteoarthritis Outcome Score, Lysholm, Tegner, and visual analog scale scales were used for patient assessment. Magnetic resonance imaging and a complete radiographic protocol were conducted to determine the degree of meniscal extrusion and the changes in the degree of osteoarthritis and coronal alignment. Assessments were performed after 2 and 7 years of follow-up. A significant improvement in all the scores, relative to preoperative values, was found after 7 years of follow-up. This improvement remained consistent throughout the first and second follow-up periods. A mean absolute extrusion of 2.2 mm ± 1.6 and an extrusion percentage of 28.0% ± 11.43 were found, with no significant differences throughout the follow-up periods. There was no statistically significant difference in terms of the frontal mechanical axis and joint space narrowing between the preoperative value and at the first and second follow-up periods. A survival rate of 85.7% was found after 7 years of follow-up. Capsulodesis results in a low degree of meniscal extrusion in isolated lateral MAT fixed with a suture-only technique, which is maintained after 7 years of follow-up, with a high graft survival index (>85%) and satisfactory results on the functional scales.

Keywords

capsular fixation - capsulodesis - lateral meniscus - meniscal extrusion - meniscal - transplantation

Full Text

References

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