Meniscal Allograft Transplantation Does Not Prevent or Delay Progression of Knee Osteoarthritis
Meniscal tears are common knee injuries. Meniscal allograft transplantation (MAT) has been advocated to alleviate symptoms and delay osteoarthritis (OA) after meniscectomy. We investigated (1) the long-term outcome of MAT as a treatment of symptomatic meniscectomy, (2) most important factors affecti...
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| description | Meniscal tears are common knee injuries. Meniscal allograft transplantation (MAT) has been advocated to alleviate symptoms and delay osteoarthritis (OA) after meniscectomy. We investigated (1) the long-term outcome of MAT as a treatment of symptomatic meniscectomy, (2) most important factors affecting survivorship and (3) OA progression.
From 1989 till 2013, 329 MAT were performed in 313 patients. Clinical and radiographic results and MAT survival were evaluated retrospectively. Failure was defined as conversion to knee arthroplasty (KA) or total removal of the MAT.
Mean age at surgery was 33 years (15-57); 60% were males. No-to-mild cartilage damage was found in 156 cases, moderate-to-severe damage in 130. Simultaneous procedures in 118 patients included cartilage procedures, osteotomy or ACL-reconstruction. At a mean follow-up of 6.8 years (0.2-24.3years), 5 patients were deceased and 48 lost (14.6%), 186 MAT were in situ (56.5%) whilst 90 (27.4%) had been removed, including 63 converted to a KA (19.2%). Cumulative allograft survivorship was 15.1% (95% CI:13.9-16.3) at 24.0 years. In patients |
| doi_str_mv | 10.1371/journal.pone.0156183 |
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From 1989 till 2013, 329 MAT were performed in 313 patients. Clinical and radiographic results and MAT survival were evaluated retrospectively. Failure was defined as conversion to knee arthroplasty (KA) or total removal of the MAT.
Mean age at surgery was 33 years (15-57); 60% were males. No-to-mild cartilage damage was found in 156 cases, moderate-to-severe damage in 130. Simultaneous procedures in 118 patients included cartilage procedures, osteotomy or ACL-reconstruction. At a mean follow-up of 6.8 years (0.2-24.3years), 5 patients were deceased and 48 lost (14.6%), 186 MAT were in situ (56.5%) whilst 90 (27.4%) had been removed, including 63 converted to a KA (19.2%). Cumulative allograft survivorship was 15.1% (95% CI:13.9-16.3) at 24.0 years. In patients <35 years at surgery, survival was significantly better (24.1%) compared to ≥35 years (8.0%) (p = 0.017). In knees with no-to-mild cartilage damage more allografts survived (43.0%) compared to moderate-to-severe damage (6.6%) (p = 0.003). Simultaneous osteotomy significantly deteriorated survival (0% at 24.0 years) (p = 0.010). 61% of patients underwent at least one additional surgery (1-11) for clinical symptoms after MAT. Consecutive radiographs showed significant OA progression at a mean of 3.8 years (p<0.0001). Incremental Kellgren-Lawrence grade was +1,1 grade per 1000 days (2,7yrs).
MAT did not delay or prevent tibiofemoral OA progression. 19.2% were converted to a knee prosthesis at a mean of 10.3 years. Patients younger than 35 with no-to-mild cartilage damage may benefit from MAT for relief of symptoms (survivorship 51.9% at 20.2 years), but patients and healthcare payers and providers should be aware of the high number of surgical re-interventions.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0156183</identifier><identifier>PMID: 27228174</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Allografts ; Arthritis ; Arthroplasty (knee) ; Biocompatibility ; Biology and Life Sciences ; Bone grafts ; Bone Transplantation ; Cartilage ; Cartilage diseases ; Complications and side effects ; Damage ; Delay ; Development and progression ; Disease Progression ; Female ; Health aspects ; Health care ; Humans ; Injuries ; Joint surgery ; Knee ; Male ; Males ; Medicine and Health Sciences ; Menisci, Tibial - transplantation ; Meniscus ; Meniscus (Anatomy) ; Middle Aged ; Orthopedic surgery ; Osteoarthritis ; Osteoarthritis, Knee - pathology ; Osteoarthritis, Knee - surgery ; Osteotomy ; Patients ; Prognosis ; Prostheses ; Radiographs ; Radiography ; Retrospective Studies ; Surgery ; Surgical implants ; Survival ; Survival Rate ; Systematic review ; Transplantation ; Young Adult</subject><ispartof>PloS one, 2016-05, Vol.11 (5), p.e0156183-e0156183</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Van Der Straeten et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Van Der Straeten et al 2016 Van Der Straeten et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-1eea0e0d2a977440cfe4780fdce077a5e8673aa957f82387f43ab421618b58fd3</citedby><cites>FETCH-LOGICAL-c692t-1eea0e0d2a977440cfe4780fdce077a5e8673aa957f82387f43ab421618b58fd3</cites><orcidid>0000-0001-5659-0853</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881946/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881946/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27228174$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Zhao, Chunfeng</contributor><creatorcontrib>Van Der Straeten, Catherine</creatorcontrib><creatorcontrib>Byttebier, Paul</creatorcontrib><creatorcontrib>Eeckhoudt, Annelies</creatorcontrib><creatorcontrib>Victor, Jan</creatorcontrib><title>Meniscal Allograft Transplantation Does Not Prevent or Delay Progression of Knee Osteoarthritis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Meniscal tears are common knee injuries. Meniscal allograft transplantation (MAT) has been advocated to alleviate symptoms and delay osteoarthritis (OA) after meniscectomy. We investigated (1) the long-term outcome of MAT as a treatment of symptomatic meniscectomy, (2) most important factors affecting survivorship and (3) OA progression.
From 1989 till 2013, 329 MAT were performed in 313 patients. Clinical and radiographic results and MAT survival were evaluated retrospectively. Failure was defined as conversion to knee arthroplasty (KA) or total removal of the MAT.
Mean age at surgery was 33 years (15-57); 60% were males. No-to-mild cartilage damage was found in 156 cases, moderate-to-severe damage in 130. Simultaneous procedures in 118 patients included cartilage procedures, osteotomy or ACL-reconstruction. At a mean follow-up of 6.8 years (0.2-24.3years), 5 patients were deceased and 48 lost (14.6%), 186 MAT were in situ (56.5%) whilst 90 (27.4%) had been removed, including 63 converted to a KA (19.2%). Cumulative allograft survivorship was 15.1% (95% CI:13.9-16.3) at 24.0 years. In patients <35 years at surgery, survival was significantly better (24.1%) compared to ≥35 years (8.0%) (p = 0.017). In knees with no-to-mild cartilage damage more allografts survived (43.0%) compared to moderate-to-severe damage (6.6%) (p = 0.003). Simultaneous osteotomy significantly deteriorated survival (0% at 24.0 years) (p = 0.010). 61% of patients underwent at least one additional surgery (1-11) for clinical symptoms after MAT. Consecutive radiographs showed significant OA progression at a mean of 3.8 years (p<0.0001). Incremental Kellgren-Lawrence grade was +1,1 grade per 1000 days (2,7yrs).
MAT did not delay or prevent tibiofemoral OA progression. 19.2% were converted to a knee prosthesis at a mean of 10.3 years. Patients younger than 35 with no-to-mild cartilage damage may benefit from MAT for relief of symptoms (survivorship 51.9% at 20.2 years), but patients and healthcare payers and providers should be aware of the high number of surgical re-interventions.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Allografts</subject><subject>Arthritis</subject><subject>Arthroplasty (knee)</subject><subject>Biocompatibility</subject><subject>Biology and Life Sciences</subject><subject>Bone grafts</subject><subject>Bone Transplantation</subject><subject>Cartilage</subject><subject>Cartilage diseases</subject><subject>Complications and side effects</subject><subject>Damage</subject><subject>Delay</subject><subject>Development and progression</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Humans</subject><subject>Injuries</subject><subject>Joint surgery</subject><subject>Knee</subject><subject>Male</subject><subject>Males</subject><subject>Medicine and Health Sciences</subject><subject>Menisci, Tibial - transplantation</subject><subject>Meniscus</subject><subject>Meniscus (Anatomy)</subject><subject>Middle Aged</subject><subject>Orthopedic surgery</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis, Knee - pathology</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Osteotomy</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Prostheses</subject><subject>Radiographs</subject><subject>Radiography</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical implants</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Systematic review</subject><subject>Transplantation</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk21v0zAQxyMEYqPwDRBEQkLwosWOndh5M6naeKgYFMHgrXVJz20mNy62M7Fvj7NmU4P2AkVKrMvv_vfguyR5TsmMMkHfXdrOtWBmO9vijNC8oJI9SI5pybJpkRH28OB8lDzx_pKQnMmieJwcZSLLJBX8OFFfsG18DSadG2PXDnRILxy0fmegDRAa26ZnFn361Yb0m8MrbENqXXqGBq6jIbqg9z1ldfq5RUyXPqAFFzauCY1_mjzSYDw-G76T5OeH9xenn6bny4-L0_n5tC7KLEwpIhAkqwxKITgntUYuJNGrGokQkKMsBAMoc6FlxqTQnEHFMxqLrnKpV2ySvNzr7oz1auiNV1SUVBalJDISiz2xsnCpdq7ZgrtWFhp1Y7BurWLWTW1QUQaUEo6kqDKuq7LKBdM6F5JXqxrKPtrJEK2rthiTbIMDMxId_2mbjVrbK8WlpCUvosCbQcDZ3x36oLbxFtDEpqPtbvLOmMgF7dFX_6D3VzdQa4gFNK22MW7di6o5z1nOWP-aJLN7qPiscNvUcZB0E-0jh7cjh8gE_BPW0HmvFj--_z-7_DVmXx-wGwQTNt6arp83Pwb5Hqyd9d6hvmsyJarfg9tuqH4P1LAH0e3F4QXdOd0OPvsL49IDEQ</recordid><startdate>20160526</startdate><enddate>20160526</enddate><creator>Van Der Straeten, Catherine</creator><creator>Byttebier, Paul</creator><creator>Eeckhoudt, Annelies</creator><creator>Victor, Jan</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-5659-0853</orcidid></search><sort><creationdate>20160526</creationdate><title>Meniscal Allograft Transplantation Does Not Prevent or Delay Progression of Knee Osteoarthritis</title><author>Van Der Straeten, Catherine ; Byttebier, Paul ; Eeckhoudt, Annelies ; Victor, Jan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-1eea0e0d2a977440cfe4780fdce077a5e8673aa957f82387f43ab421618b58fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Allografts</topic><topic>Arthritis</topic><topic>Arthroplasty (knee)</topic><topic>Biocompatibility</topic><topic>Biology and Life Sciences</topic><topic>Bone grafts</topic><topic>Bone Transplantation</topic><topic>Cartilage</topic><topic>Cartilage diseases</topic><topic>Complications and side effects</topic><topic>Damage</topic><topic>Delay</topic><topic>Development and progression</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Humans</topic><topic>Injuries</topic><topic>Joint surgery</topic><topic>Knee</topic><topic>Male</topic><topic>Males</topic><topic>Medicine and Health Sciences</topic><topic>Menisci, Tibial - transplantation</topic><topic>Meniscus</topic><topic>Meniscus (Anatomy)</topic><topic>Middle Aged</topic><topic>Orthopedic surgery</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis, Knee - pathology</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Osteotomy</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Prostheses</topic><topic>Radiographs</topic><topic>Radiography</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical implants</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Systematic review</topic><topic>Transplantation</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van Der Straeten, Catherine</creatorcontrib><creatorcontrib>Byttebier, Paul</creatorcontrib><creatorcontrib>Eeckhoudt, Annelies</creatorcontrib><creatorcontrib>Victor, Jan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van Der Straeten, Catherine</au><au>Byttebier, Paul</au><au>Eeckhoudt, Annelies</au><au>Victor, Jan</au><au>Zhao, Chunfeng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Meniscal Allograft Transplantation Does Not Prevent or Delay Progression of Knee Osteoarthritis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-05-26</date><risdate>2016</risdate><volume>11</volume><issue>5</issue><spage>e0156183</spage><epage>e0156183</epage><pages>e0156183-e0156183</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Meniscal tears are common knee injuries. Meniscal allograft transplantation (MAT) has been advocated to alleviate symptoms and delay osteoarthritis (OA) after meniscectomy. We investigated (1) the long-term outcome of MAT as a treatment of symptomatic meniscectomy, (2) most important factors affecting survivorship and (3) OA progression.
From 1989 till 2013, 329 MAT were performed in 313 patients. Clinical and radiographic results and MAT survival were evaluated retrospectively. Failure was defined as conversion to knee arthroplasty (KA) or total removal of the MAT.
Mean age at surgery was 33 years (15-57); 60% were males. No-to-mild cartilage damage was found in 156 cases, moderate-to-severe damage in 130. Simultaneous procedures in 118 patients included cartilage procedures, osteotomy or ACL-reconstruction. At a mean follow-up of 6.8 years (0.2-24.3years), 5 patients were deceased and 48 lost (14.6%), 186 MAT were in situ (56.5%) whilst 90 (27.4%) had been removed, including 63 converted to a KA (19.2%). Cumulative allograft survivorship was 15.1% (95% CI:13.9-16.3) at 24.0 years. In patients <35 years at surgery, survival was significantly better (24.1%) compared to ≥35 years (8.0%) (p = 0.017). In knees with no-to-mild cartilage damage more allografts survived (43.0%) compared to moderate-to-severe damage (6.6%) (p = 0.003). Simultaneous osteotomy significantly deteriorated survival (0% at 24.0 years) (p = 0.010). 61% of patients underwent at least one additional surgery (1-11) for clinical symptoms after MAT. Consecutive radiographs showed significant OA progression at a mean of 3.8 years (p<0.0001). Incremental Kellgren-Lawrence grade was +1,1 grade per 1000 days (2,7yrs).
MAT did not delay or prevent tibiofemoral OA progression. 19.2% were converted to a knee prosthesis at a mean of 10.3 years. Patients younger than 35 with no-to-mild cartilage damage may benefit from MAT for relief of symptoms (survivorship 51.9% at 20.2 years), but patients and healthcare payers and providers should be aware of the high number of surgical re-interventions.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27228174</pmid><doi>10.1371/journal.pone.0156183</doi><orcidid>https://orcid.org/0000-0001-5659-0853</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adult Allografts Arthritis Arthroplasty (knee) Biocompatibility Biology and Life Sciences Bone grafts Bone Transplantation Cartilage Cartilage diseases Complications and side effects Damage Delay Development and progression Disease Progression Female Health aspects Health care Humans Injuries Joint surgery Knee Male Males Medicine and Health Sciences Menisci, Tibial - transplantation Meniscus Meniscus (Anatomy) Middle Aged Orthopedic surgery Osteoarthritis Osteoarthritis, Knee - pathology Osteoarthritis, Knee - surgery Osteotomy Patients Prognosis Prostheses Radiographs Radiography Retrospective Studies Surgery Surgical implants Survival Survival Rate Systematic review Transplantation Young Adult |
| title | Meniscal Allograft Transplantation Does Not Prevent or Delay Progression of Knee Osteoarthritis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T23%3A29%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Meniscal%20Allograft%20Transplantation%20Does%20Not%20Prevent%20or%20Delay%20Progression%20of%20Knee%20Osteoarthritis&rft.jtitle=PloS%20one&rft.au=Van%20Der%20Straeten,%20Catherine&rft.date=2016-05-26&rft.volume=11&rft.issue=5&rft.spage=e0156183&rft.epage=e0156183&rft.pages=e0156183-e0156183&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0156183&rft_dat=%3Cgale_plos_%3EA453533535%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1791869808&rft_id=info:pmid/27228174&rft_galeid=A453533535&rft_doaj_id=oai_doaj_org_article_13a1104e06b24fb9b573ff5784bdca9d&rfr_iscdi=true |