J Knee Surg 2021; 34(03): 303-321
DOI: 10.1055/s-0039-1695043
Original Article

Predictors of Meniscal Allograft Transplantation Outcome: A Systematic Review

Daniele Fanelli
1   Aberdeen Royal Infirmary, Foresterhill Health Campus, Aberdeen, United Kingdom
,
2   Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University, “Mater Domini” University Hospital, V.le Europa (loc. Germaneto), Catanzaro, Italy
,
Giorgio Gasparini
2   Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University, “Mater Domini” University Hospital, V.le Europa (loc. Germaneto), Catanzaro, Italy
,
Olimpio Galasso
2   Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University, “Mater Domini” University Hospital, V.le Europa (loc. Germaneto), Catanzaro, Italy
› Institutsangaben

Abstract

This systematic review investigates factors associated with outcomes after meniscal allograft transplantation (MAT). The PubMed, Scopus, and Cochrane Central Register databases were used to search relevant articles in April 2018. Studies that evaluated at least one association between a factor and outcomes were extracted. Of 3,381 titles, 52 studies were finally analyzed. Data about predictors, patient-reported outcome scores (PROMs), and failure rates were extracted for quantitative and qualitative analysis. A total of 3,382 patients and 3,460 transplants were identified. Thirty different predictors were reported in the current MAT literature, 18 of which by at least two studies. Subgroup analysis showed that lateral MAT had higher postoperative values than medial MAT in Lysholm's (p = 0.0102) and International Knee Documentation Committee (IKDC; p = 0.0056) scores. Soft tissue fixation showed higher postoperative IKDC scores than bone fixation (p = 0.0008). Fresh frozen allografts had higher Lysholm's scores (p < 0.0001) and showed significantly lower failure rates (p < 0.0001) than cryopreserved allografts. Age (p < 0.015, β = 0.80), sex (p < 0.034, β=   8.52), and body mass index (BMI; p < 0.014, β = −4.87) demonstrated an association with PROMs in the regression model. Qualitative analysis found moderate evidence that a higher number of previous procedures in the same knee are an independent predictor of transplant failure. Conflicting evidence was found with regard to chondral damage, time from meniscectomy, smoke, sport level, worker's compensation status, and preoperative Lysholm's score as predictors of outcomes. Our review suggests that the ideal candidate to undergo MAT may be a young male of normal weight with no previous knee surgeries, treated with a lateral isolated procedure. However, MAT is associated with good outcomes in the majority of patients with many of the PROMs requiring further study to determine their direct effects on long-term outcomes. This study is a systematic review and reflects level of evidence IV.



Publikationsverlauf

Eingereicht: 27. März 2019

Angenommen: 15. Juli 2019

Artikel online veröffentlicht:
28. August 2019

© 2019. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Milachowski KA, Weismeier K, Wirth CJ. Homologous meniscus transplantation. Experimental and clinical results. Int Orthop 1989; 13 (01) 1-11
  • 2 Elattar M, Dhollander A, Verdonk R, Almqvist KF, Verdonk P. Twenty-six years of meniscal allograft transplantation: is it still experimental? A meta-analysis of 44 trials. Knee Surg Sports Traumatol Arthrosc 2011; 19 (02) 147-157
  • 3 De Bruycker M, Verdonk PCM, Verdonk RC. Meniscal allograft transplantation: a meta-analysis. SICOT J 2017; 3: 33
  • 4 Smith NA, Costa ML, Spalding T. Meniscal allograft transplantation: rationale for treatment. Bone Joint J 2015; 97-B (05) 590-594
  • 5 Smith NA, Parkinson B, Hutchinson CE, Costa ML, Spalding T. Is meniscal allograft transplantation chondroprotective? A systematic review of radiological outcomes. Knee Surg Sports Traumatol Arthrosc 2016; 24 (09) 2923-2935
  • 6 Smith NA, Parsons N, Wright D. et al. A pilot randomized trial of meniscal allograft transplantation versus personalized physiotherapy for patients with a symptomatic meniscal deficient knee compartment. Bone Joint J 2018; 100-B (01) 56-63
  • 7 Rosso F, Bisicchia S, Bonasia DE, Amendola A. Meniscal allograft transplantation: a systematic review. Am J Sports Med 2015; 43 (04) 998-1007
  • 8 Myers P, Tudor F. Meniscal allograft transplantation: how should we be doing it? A systematic review. Arthroscopy 2015; 31 (05) 911-925
  • 9 Samitier G, Alentorn-Geli E, Taylor DC. et al. Meniscal allograft transplantation. Part 1: systematic review of graft biology, graft shrinkage, graft extrusion, graft sizing, and graft fixation. Knee Surg Sports Traumatol Arthrosc 2015; 23 (01) 310-322
  • 10 Samitier G, Alentorn-Geli E, Taylor DC. et al. Meniscal allograft transplantation. Part 2: systematic review of transplant timing, outcomes, return to competition, associated procedures, and prevention of osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2015; 23 (01) 323-333
  • 11 Rijk PC. Meniscal allograft transplantation--part I: background, results, graft selection and preservation, and surgical considerations. Arthroscopy 2004; 20 (07) 728-743
  • 12 Rijk PC. Meniscal allograft transplantation--part II: alternative treatments, effects on articular cartilage, and future directions. Arthroscopy 2004; 20 (08) 851-859
  • 13 Harris JD, Cavo M, Brophy R, Siston R, Flanigan D. Biological knee reconstruction: a systematic review of combined meniscal allograft transplantation and cartilage repair or restoration. Arthroscopy 2011; 27 (03) 409-418
  • 14 Smith NA, MacKay N, Costa M, Spalding T. Meniscal allograft transplantation in a symptomatic meniscal deficient knee: a systematic review. Knee Surg Sports Traumatol Arthrosc 2015; 23 (01) 270-279
  • 15 Bin SI, Nha KW, Cheong JY, Shin YS. Midterm and long-term results of medial versus lateral meniscal allograft transplantation: a meta-analysis. Am J Sports Med 2018; 46 (05) 1243-1250
  • 16 Lee BS, Kim HJ, Lee CR. et al. Clinical outcomes of meniscal allograft transplantation with or without other procedures: a systematic review and meta-analysis. Am J Sports Med 2018; 46 (12) 3047-3056
  • 17 Jauregui JJ, Wu ZD, Meredith S, Griffith C, Packer JD, Henn III RF. How should we secure our transplanted meniscus? A meta-analysis. Am J Sports Med 2018; 46 (09) 2285-2290
  • 18 Moher D, Liberati A, Tetzlaff J, Altman DG. ; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 26 (07) e1000097
  • 19 Hayden JA, van der Windt DA, Cartwright JL, Côté P, Bombardier C. Assessing bias in studies of prognostic factors. Ann Intern Med 2013; 158 (04) 280-286
  • 20 Slavin RE. Best evidence synthesis: an intelligent alternative to meta-analysis. J Clin Epidemiol 1995; 48 (01) 9-18
  • 21 van Tulder M, Furlan A, Bombardier C, Bouter L. ; Editorial Board of the Cochrane Collaboration Back Review Group. Updated method guidelines for systematic reviews in the cochrane collaboration back review group. Spine 2003; 28 (12) 1290-1299
  • 22 Eijgenraam SM, Reijman M, Bierma-Zeinstra SMA, van Yperen DT, Meuffels DE. Can we predict the clinical outcome of arthroscopic partial meniscectomy? A systematic review. Br J Sports Med 2018; 52 (08) 514-521
  • 23 McElvany MD, McGoldrick E, Gee AO, Neradilek MB, Matsen III FA. Rotator cuff repair: published evidence on factors associated with repair integrity and clinical outcome. Am J Sports Med 2015; 43 (02) 491-500
  • 24 Masferrer-Pino A, Monllau JC, Ibáñez M, Erquicia JI, Pelfort X, Gelber PE. Capsulodesis versus bone trough technique in lateral meniscal allograft transplantation: graft extrusion and functional results. Arthroscopy 2018; 34 (06) 1879-1888
  • 25 Chalmers PN, Karas V, Sherman SL, Cole BJ. Return to high-level sport after meniscal allograft transplantation. Arthroscopy 2013; 29 (03) 539-544
  • 26 Van Der Straeten C, Byttebier P, Eeckhoudt A, Victor J. Meniscal allograft transplantation does not prevent or delay progression of knee osteoarthritis. PLoS One 2016; 11 (05) e0156183
  • 27 Stone KR, Walgenbach AW, Turek TJ, Freyer A, Hill MD. Meniscus allograft survival in patients with moderate to severe unicompartmental arthritis: a 2- to 7-year follow-up. Arthroscopy 2006; 22 (05) 469-478
  • 28 Jang SH, Kim JG, Ha JG, Shim JC. Reducing the size of the meniscal allograft decreases the percentage of extrusion after meniscal allograft transplantation. Arthroscopy 2011; 27 (07) 914-922
  • 29 Kazi HA, Abdel-Rahman W, Brady PA, Cameron JC. Meniscal allograft with or without osteotomy: a 15-year follow-up study. Knee Surg Sports Traumatol Arthrosc 2015; 23 (01) 303-309
  • 30 Noyes FR, Barber-Westin SD. Long-term survivorship and function of meniscus transplantation. Am J Sports Med 2016; 44 (09) 2330-2338
  • 31 Abat F, Gelber PE, Erquicia JI, Tey M, Gonzalez-Lucena G, Monllau JC. Prospective comparative study between two different fixation techniques in meniscal allograft transplantation. Knee Surg Sports Traumatol Arthrosc 2013; 21 (07) 1516-1522
  • 32 Yoon KH, Lee SH, Park SY, Kim HJ, Chung KY. Meniscus allograft transplantation: a comparison of medial and lateral procedures. Am J Sports Med 2014; 42 (01) 200-207
  • 33 Saltzman BM, Meyer MA, Leroux TS. et al. The influence of full-thickness chondral defects on outcomes following meniscal allograft transplantation: a comparative study. Arthroscopy 2018; 34 (02) 519-529
  • 34 Stone KR, Adelson WS, Pelsis JR, Walgenbach AW, Turek TJ. Long-term survival of concurrent meniscus allograft transplantation and repair of the articular cartilage: a prospective two- to 12-year follow-up report. J Bone Joint Surg Br 2010; 92 (07) 941-948
  • 35 Parkinson B, Smith N, Asplin L, Thompson P, Spalding T. Factors predicting meniscal allograft transplantation failure. Orthop J Sports Med 2016; 4 (08) 2325967116663185
  • 36 Mahmoud A, Young J, Bullock-Saxton J, Myers P. Meniscal allograft transplantation: the effect of cartilage status on survivorship and clinical outcome. Arthroscopy 2018; 34 (06) 1871-1876.e1
  • 37 LaPrade RF, Wills NJ, Spiridonov SI, Perkinson S. A prospective outcomes study of meniscal allograft transplantation. Am J Sports Med 2010; 38 (09) 1804-1812
  • 38 Ogura T, Bryant T, Minas T. Biological knee reconstruction with concomitant autologous chondrocyte implantation and meniscal allograft transplantation. Orthop J Sports Med 2016; 4 (10) 2325967116668490
  • 39 Abrams GD, Hussey KE, Harris JD, Cole BJ. Clinical results of combined meniscus and femoral osteochondral allograft transplantation: minimum 2-year follow-up. Arthroscopy 2014; 30 (08) 964-70.e1
  • 40 Kempshall PJ, Parkinson B, Thomas M. et al. Outcome of meniscal allograft transplantation related to articular cartilage status: advanced chondral damage should not be a contraindication. Knee Surg Sports Traumatol Arthrosc 2015; 23 (01) 280-289
  • 41 Zaffagnini S, Grassi A, Marcheggiani Muccioli GM. et al. Survivorship and clinical outcomes of 147 consecutive isolated or combined arthroscopic bone plug free meniscal allograft transplantation. Knee Surg Sports Traumatol Arthrosc 2016; 24 (05) 1432-1439
  • 42 van der Wal RJ, Thomassen BJ, van Arkel ER. Long-term clinical outcome of open meniscal allograft transplantation. Am J Sports Med 2009; 37 (11) 2134-2139
  • 43 Vundelinckx B, Bellemans J, Vanlauwe J. Arthroscopically assisted meniscal allograft transplantation in the knee: a medium-term subjective, clinical, and radiographical outcome evaluation. Am J Sports Med 2010; 38 (11) 2240-2247
  • 44 Ryu RK, Dunbar V WH, Morse GG. Meniscal allograft replacement: a 1-year to 6-year experience. Arthroscopy 2002; 18 (09) 989-994
  • 45 van Arkel ER, de Boer HH. Survival analysis of human meniscal transplantations. J Bone Joint Surg Br 2002; 84 (02) 227-231
  • 46 Lee BS, Bin SI, Kim JM, Kim WK, Choi JW. Survivorship after meniscal allograft transplantation according to articular cartilage status. Am J Sports Med 2017; 45 (05) 1095-1101
  • 47 Waterman BR, Rensing N, Cameron KL, Owens BD, Pallis M. Survivorship of meniscal allograft transplantation in an athletic patient population. Am J Sports Med 2016; 44 (05) 1237-1242
  • 48 McCormick F, Harris JD, Abrams GD. et al. Survival and reoperation rates after meniscal allograft transplantation: analysis of failures for 172 consecutive transplants at a minimum 2-year follow-up. Am J Sports Med 2014; 42 (04) 892-897
  • 49 Saltzman BM, Meyer MA, Weber AE, Poland SG, Yanke AB, Cole BJ. Prospective clinical and radiographic outcomes after concomitant anterior cruciate ligament reconstruction and meniscal allograft transplantation at a mean 5-year follow-up. Am J Sports Med 2017; 45 (03) 550-562
  • 50 Saltzman BM, Bajaj S, Salata M. et al. Prospective long-term evaluation of meniscal allograft transplantation procedure: a minimum of 7-year follow-up. J Knee Surg 2012; 25 (02) 165-175
  • 51 Marcacci M, Zaffagnini S, Marcheggiani Muccioli GM. et al. Meniscal allograft transplantation without bone plugs: a 3-year minimum follow-up study. Am J Sports Med 2012; 40 (02) 395-403
  • 52 Alentorn-Geli E, Seijas Vázquez R, García Balletbó M. et al. Arthroscopic meniscal allograft transplantation without bone plugs. Knee Surg Sports Traumatol Arthrosc 2011; 19 (02) 174-182
  • 53 Stollsteimer GT, Shelton WR, Dukes A, Bomboy AL. Meniscal allograft transplantation: a 1- to 5-year follow-up of 22 patients. Arthroscopy 2000; 16 (04) 343-347
  • 54 Yoldas EA, Sekiya JK, Irrgang JJ, Fu FH, Harner CD. Arthroscopically assisted meniscal allograft transplantation with and without combined anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2003; 11 (03) 173-182
  • 55 Verdonk PC, Verstraete KL, Almqvist KF. et al. Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations. Knee Surg Sports Traumatol Arthrosc 2006; 14 (08) 694-706
  • 56 Verdonk PC, Demurie A, Almqvist KF, Veys EM, Verbruggen G, Verdonk R. Transplantation of viable meniscal allograft. Surgical technique. J Bone Joint Surg Am 2006; 88 (Suppl 1 Pt 1): 109-118
  • 57 Noyes FR, Barber-Westin SD, Rankin M. Meniscal transplantation in symptomatic patients less than fifty years old. J Bone Joint Surg Am 2005; 87 (Pt 2, Suppl 1) 149-165
  • 58 Lee DH, Kim SB, Kim TH, Cha EJ, Bin SI. Midterm outcomes after meniscal allograft transplantation: comparison of cases with extrusion versus without extrusion. Am J Sports Med 2010; 38 (02) 247-254
  • 59 Sekiya JK, West RV, Groff YJ, Irrgang JJ, Fu FH, Harner CD. Clinical outcomes following isolated lateral meniscal allograft transplantation. Arthroscopy 2006; 22 (07) 771-780
  • 60 Jeon B, Kim JM, Kim JM, Lee CR, Kim KA, Bin SI. An osteophyte in the tibial plateau is a risk factor for allograft extrusion after meniscus allograft transplantation. Am J Sports Med 2015; 43 (05) 1215-1221
  • 61 Jiang D, Ao YF, Gong X, Wang YJ, Zheng ZZ, Yu JK. Comparative study on immediate versus delayed meniscus allograft transplantation: 4- to 6-year follow-up. Am J Sports Med 2014; 42 (10) 2329-2337
  • 62 Hommen JP, Applegate GR, Del Pizzo W. Meniscus allograft transplantation: ten-year results of cryopreserved allografts. Arthroscopy 2007; 23 (04) 388-393
  • 63 Cameron JC, Saha S. Meniscal allograft transplantation for unicompartmental arthritis of the knee. Clin Orthop Relat Res 1997; (337) 164-171
  • 64 Faivre B, Boisrenoult P, Lonjon G, Pujol N, Beaufils P. Lateral meniscus allograft transplantation: clinical and anatomic outcomes after arthroscopic implantation with tibial tunnels versus open implantation without tunnels. Orthop Traumatol Surg Res 2014; 100 (03) 297-302
  • 65 Saltzman BM, Cotter EJ, Stephens JP. et al. Preoperative tibial subchondral bone marrow lesion patterns and associations with outcomes after isolated meniscus allograft transplantation. Am J Sports Med 2018; 46 (05) 1175-1184
  • 66 Barber-Westin SD, Noyes FR. Low-impact sports activities are feasible after meniscus transplantation: a systematic review. Knee Surg Sports Traumatol Arthrosc 2018; 26 (07) 1950-1958
  • 67 Makris EA, Hadidi P, Athanasiou KA. The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration. Biomaterials 2011; 32 (30) 7411-7431
  • 68 McDermott ID, Lie DT, Edwards A, Bull AM, Amis AA. The effects of lateral meniscal allograft transplantation techniques on tibio-femoral contact pressures. Knee Surg Sports Traumatol Arthrosc 2008; 16 (06) 553-560
  • 69 Alhalki MM, Howell SM, Hull ML. How three methods for fixing a medial meniscal autograft affect tibial contact mechanics. Am J Sports Med 1999; 27 (03) 320-328
  • 70 Abat F, Gelber PE, Erquicia JI, Pelfort X, Gonzalez-Lucena G, Monllau JC. Suture-only fixation technique leads to a higher degree of extrusion than bony fixation in meniscal allograft transplantation. Am J Sports Med 2012; 40 (07) 1591-1596
  • 71 Ha JK, Shim JC, Kim DW, Lee YS, Ra HJ, Kim JG. Relationship between meniscal extrusion and various clinical findings after meniscus allograft transplantation. Am J Sports Med 2010; 38 (12) 2448-2455
  • 72 Koh YG, Moon HK, Kim YC, Park YS, Jo SB, Kwon SK. Comparison of medial and lateral meniscal transplantation with regard to extrusion of the allograft, and its correlation with clinical outcome. J Bone Joint Surg Br 2012; 94 (02) 190-193
  • 73 Garrett J. Meniscal transplantation:A review of 43 cases with 2 to 7 year follow-up. Sports Med Arthrosc Rev 1993; 1 (02) 164-167
  • 74 Potter HG, Rodeo SA, Wickiewicz TL, Warren RF. MR imaging of meniscal allografts: correlation with clinical and arthroscopic outcomes. Radiology 1996; 198 (02) 509-514
  • 75 Cole JB, Saltzman BM, Bajaj S. et al. Prospective long-term evaluation of allograft meniscus transplantation: a minimum 7-year follow-up. Arthroscopy 2011; 27 (05) e48
  • 76 Farr J, Rawal A, Marberry KM. Concomitant meniscal allograft transplantation and autologous chondrocyte implantation: minimum 2-year follow-up. Am J Sports Med 2007; 35 (09) 1459-1466
  • 77 González-Lucena G, Gelber PE, Pelfort X, Tey M, Monllau JC. Meniscal allograft transplantation without bone blocks: a 5- to 8-year follow-up of 33 patients. Arthroscopy 2010; 26 (12) 1633-1640
  • 78 Kim JM, Bin SI, Lee BS. et al. Long-term survival analysis of meniscus allograft transplantation with bone fixation. Arthroscopy 2017; 33 (02) 387-393
  • 79 Noyes FR, Barber-Westin SD. Meniscal transplantation in symptomatic patients under fifty years of age. J Bone Joint Surg Am 2015; 97 (15) 1209-1219
  • 80 Peng L, Zhu W, Zhu W, Lu W, Cui J, Chen K. Comparison of the bone plug and bone bridge technique for lateral meniscus allograft transplantation. Int J Clin Exp Med 2016; 9 (11) 21866-21871
  • 81 Yoon KH, Lee SH, Park SY, Jung GY, Chung KY. Meniscus allograft transplantation for discoid lateral meniscus: clinical comparison between discoid lateral meniscus and nondiscoid lateral meniscus. Arthroscopy 2014; 30 (06) 724-730
  • 82 Zhang H, Liu X, Wei Y. et al. Meniscal allograft transplantation in isolated and combined surgery. Knee Surg Sports Traumatol Arthrosc 2012; 20 (02) 281-289