Graft Extrusion in Both the Coronal and Sagittal Planes Is Greater After Medial Compared With Lateral Meniscus Allograft Transplantation but Is Unrelated to Early Clinical Outcomes

Background: Graft extrusion after meniscus allograft transplantation (MAT) may be affected by horn fixation, which differs between medial and lateral MAT. Few studies have compared graft extrusion, especially sagittal extrusion, after medial and lateral MAT. Hypothesis: In patients undergoing medial...

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Veröffentlicht in:The American journal of sports medicine 2015-01, Vol.43 (1), p.213-219
Hauptverfasser: Lee, Dae-Hee, Lee, Chang-Rack, Jeon, Jin-Ho, Kim, Kyung-Ah, Bin, Seong-Il
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container_start_page 213
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creator Lee, Dae-Hee
Lee, Chang-Rack
Jeon, Jin-Ho
Kim, Kyung-Ah
Bin, Seong-Il
description Background: Graft extrusion after meniscus allograft transplantation (MAT) may be affected by horn fixation, which differs between medial and lateral MAT. Few studies have compared graft extrusion, especially sagittal extrusion, after medial and lateral MAT. Hypothesis: In patients undergoing medial and lateral MAT, graft extrusion is likely similar and not correlated with postoperative Lysholm scores. Study Design: Cohort study; Level of evidence, 2. Methods: Meniscus graft extrusion in the coronal and sagittal planes was compared in 51 knees undergoing medial MAT and 84 undergoing lateral MAT. Distances from the anterior and posterior articular cartilage margins to the anterior (anterior cartilage meniscus distance [ACMD]) and posterior (posterior cartilage meniscus distance [PCMD]) horns, respectively, were assessed on immediate postoperative magnetic resonance imaging and compared in patients undergoing medial and lateral MAT. Correlations between coronal and sagittal graft extrusion and between extrusion and the Lysholm score were compared in the 2 groups. Results: In the coronal plane, mean absolute (4.3 vs 2.7 mm, respectively; P < .001) and relative (39% vs 21%, respectively; P < .001) graft extrusions were significantly greater for medial than lateral MAT. In the sagittal plane, mean absolute and relative ACMD and PCMD values were significantly greater for medial than lateral MAT (P < .001 each). For both medial and lateral MAT, mean absolute and relative ACMDs were significantly larger than PCMDs (P < .001 each). Graft extrusion >3 mm in the coronal plane was significantly more frequent in the medial (78%) than in the lateral (35%) MAT group. In the sagittal plane, the frequencies of ACMDs (72% vs 39%, respectively) and PCMDs (23% vs 4%, respectively) >3 mm were also significantly greater in the medial than in the lateral MAT group. Coronal and sagittal extrusions were not correlated with postoperative Lysholm scores for both medial and lateral MAT. Conclusion: The amount and incidence of graft extrusion were greater after medial than lateral MAT in both the coronal and sagittal planes. In the sagittal plane, graft extrusion was greater and more frequent on the anterior than the posterior horn in both medial and lateral MAT. However, graft extrusion was not correlated with early clinical outcomes after both medial and lateral MAT.
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Few studies have compared graft extrusion, especially sagittal extrusion, after medial and lateral MAT. Hypothesis: In patients undergoing medial and lateral MAT, graft extrusion is likely similar and not correlated with postoperative Lysholm scores. Study Design: Cohort study; Level of evidence, 2. Methods: Meniscus graft extrusion in the coronal and sagittal planes was compared in 51 knees undergoing medial MAT and 84 undergoing lateral MAT. Distances from the anterior and posterior articular cartilage margins to the anterior (anterior cartilage meniscus distance [ACMD]) and posterior (posterior cartilage meniscus distance [PCMD]) horns, respectively, were assessed on immediate postoperative magnetic resonance imaging and compared in patients undergoing medial and lateral MAT. Correlations between coronal and sagittal graft extrusion and between extrusion and the Lysholm score were compared in the 2 groups. Results: In the coronal plane, mean absolute (4.3 vs 2.7 mm, respectively; P &lt; .001) and relative (39% vs 21%, respectively; P &lt; .001) graft extrusions were significantly greater for medial than lateral MAT. In the sagittal plane, mean absolute and relative ACMD and PCMD values were significantly greater for medial than lateral MAT (P &lt; .001 each). For both medial and lateral MAT, mean absolute and relative ACMDs were significantly larger than PCMDs (P &lt; .001 each). Graft extrusion &gt;3 mm in the coronal plane was significantly more frequent in the medial (78%) than in the lateral (35%) MAT group. In the sagittal plane, the frequencies of ACMDs (72% vs 39%, respectively) and PCMDs (23% vs 4%, respectively) &gt;3 mm were also significantly greater in the medial than in the lateral MAT group. Coronal and sagittal extrusions were not correlated with postoperative Lysholm scores for both medial and lateral MAT. Conclusion: The amount and incidence of graft extrusion were greater after medial than lateral MAT in both the coronal and sagittal planes. In the sagittal plane, graft extrusion was greater and more frequent on the anterior than the posterior horn in both medial and lateral MAT. However, graft extrusion was not correlated with early clinical outcomes after both medial and lateral MAT.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546514555699</identifier><identifier>PMID: 25389368</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Adult ; Allografts - pathology ; Arthroplasty ; Cartilage ; Clinical outcomes ; Correlation analysis ; Female ; Humans ; Knee ; Knee Joint - physiopathology ; Longitudinal Studies ; Lysholm Knee Score ; Magnetic Resonance Imaging - methods ; Male ; Menisci, Tibial - pathology ; Menisci, Tibial - transplantation ; Middle Aged ; NMR ; Nuclear magnetic resonance ; Postoperative Period ; Prospective Studies ; Sports medicine ; Transplants &amp; implants ; Young Adult</subject><ispartof>The American journal of sports medicine, 2015-01, Vol.43 (1), p.213-219</ispartof><rights>2014 The Author(s)</rights><rights>2014 The Author(s).</rights><rights>Copyright Sage Publications Ltd. Jan 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-ce2f7364dd1264f3803a2f199a6276d5cc6b2e97351eb542d916af5c5030186a3</citedby><cites>FETCH-LOGICAL-c398t-ce2f7364dd1264f3803a2f199a6276d5cc6b2e97351eb542d916af5c5030186a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546514555699$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546514555699$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25389368$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Dae-Hee</creatorcontrib><creatorcontrib>Lee, Chang-Rack</creatorcontrib><creatorcontrib>Jeon, Jin-Ho</creatorcontrib><creatorcontrib>Kim, Kyung-Ah</creatorcontrib><creatorcontrib>Bin, Seong-Il</creatorcontrib><title>Graft Extrusion in Both the Coronal and Sagittal Planes Is Greater After Medial Compared With Lateral Meniscus Allograft Transplantation but Is Unrelated to Early Clinical Outcomes</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background: Graft extrusion after meniscus allograft transplantation (MAT) may be affected by horn fixation, which differs between medial and lateral MAT. Few studies have compared graft extrusion, especially sagittal extrusion, after medial and lateral MAT. Hypothesis: In patients undergoing medial and lateral MAT, graft extrusion is likely similar and not correlated with postoperative Lysholm scores. Study Design: Cohort study; Level of evidence, 2. Methods: Meniscus graft extrusion in the coronal and sagittal planes was compared in 51 knees undergoing medial MAT and 84 undergoing lateral MAT. Distances from the anterior and posterior articular cartilage margins to the anterior (anterior cartilage meniscus distance [ACMD]) and posterior (posterior cartilage meniscus distance [PCMD]) horns, respectively, were assessed on immediate postoperative magnetic resonance imaging and compared in patients undergoing medial and lateral MAT. Correlations between coronal and sagittal graft extrusion and between extrusion and the Lysholm score were compared in the 2 groups. Results: In the coronal plane, mean absolute (4.3 vs 2.7 mm, respectively; P &lt; .001) and relative (39% vs 21%, respectively; P &lt; .001) graft extrusions were significantly greater for medial than lateral MAT. In the sagittal plane, mean absolute and relative ACMD and PCMD values were significantly greater for medial than lateral MAT (P &lt; .001 each). For both medial and lateral MAT, mean absolute and relative ACMDs were significantly larger than PCMDs (P &lt; .001 each). Graft extrusion &gt;3 mm in the coronal plane was significantly more frequent in the medial (78%) than in the lateral (35%) MAT group. In the sagittal plane, the frequencies of ACMDs (72% vs 39%, respectively) and PCMDs (23% vs 4%, respectively) &gt;3 mm were also significantly greater in the medial than in the lateral MAT group. Coronal and sagittal extrusions were not correlated with postoperative Lysholm scores for both medial and lateral MAT. Conclusion: The amount and incidence of graft extrusion were greater after medial than lateral MAT in both the coronal and sagittal planes. In the sagittal plane, graft extrusion was greater and more frequent on the anterior than the posterior horn in both medial and lateral MAT. However, graft extrusion was not correlated with early clinical outcomes after both medial and lateral MAT.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Allografts - pathology</subject><subject>Arthroplasty</subject><subject>Cartilage</subject><subject>Clinical outcomes</subject><subject>Correlation analysis</subject><subject>Female</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Joint - physiopathology</subject><subject>Longitudinal Studies</subject><subject>Lysholm Knee Score</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Menisci, Tibial - pathology</subject><subject>Menisci, Tibial - transplantation</subject><subject>Middle Aged</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Postoperative Period</subject><subject>Prospective Studies</subject><subject>Sports medicine</subject><subject>Transplants &amp; implants</subject><subject>Young Adult</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9rFDEUgINY7LZ69yQBL15G82OSmRzXYd0WtrRgi8chm2S2UzLJmmSg_b_8A026VaQgvSTkve99j7wHwHuMPmPcNF8Q5ZTVnOGaMcaFeAUWmDFSUcrZa7Ao6arkj8FJjHcIIdzw9g04Joy2gvJ2AX6tgxwSXN2nMMfROzg6-NWnW5huDex88E5aKJ2G3-VuTCk_rqx0JsLzCNfByGQCXA7lvDB6zOnOT3sZjIY_xmzZFCBHL4wbo5ojXFrrd48tr4N0cZ9lSabSeDunIr1xwdhcpWHycCWDfYCdHd2osuVyTspPJr4FR4O00bx7uk_BzbfVdXdWbS7X591yUykq2lQpQ4aG8lprTHg90BZRSQYshOSk4ZopxbfEiIYybLasJlpgLgemGKIIt1zSU_Dp4N0H_3M2MfVT_oWxZQJ-jj1uEK5FI4h4GeU1bhmnlGX04zP0zs8hz7lQjOBWEIwyhQ6UCj7GYIZ-H8ZJhoceo74sv3--_Fzy4Uk8byej_xb82XYGqgMQ5c780_V_wt8Y0rcX</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Lee, Dae-Hee</creator><creator>Lee, Chang-Rack</creator><creator>Jeon, Jin-Ho</creator><creator>Kim, Kyung-Ah</creator><creator>Bin, Seong-Il</creator><general>SAGE Publications</general><general>Sage Publications Ltd</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>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20150101</creationdate><title>Graft Extrusion in Both the Coronal and Sagittal Planes Is Greater After Medial Compared With Lateral Meniscus Allograft Transplantation but Is Unrelated to Early Clinical Outcomes</title><author>Lee, Dae-Hee ; Lee, Chang-Rack ; Jeon, Jin-Ho ; Kim, Kyung-Ah ; Bin, Seong-Il</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-ce2f7364dd1264f3803a2f199a6276d5cc6b2e97351eb542d916af5c5030186a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Allografts - pathology</topic><topic>Arthroplasty</topic><topic>Cartilage</topic><topic>Clinical outcomes</topic><topic>Correlation analysis</topic><topic>Female</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Joint - physiopathology</topic><topic>Longitudinal Studies</topic><topic>Lysholm Knee Score</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Menisci, Tibial - pathology</topic><topic>Menisci, Tibial - transplantation</topic><topic>Middle Aged</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Postoperative Period</topic><topic>Prospective Studies</topic><topic>Sports medicine</topic><topic>Transplants &amp; implants</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Dae-Hee</creatorcontrib><creatorcontrib>Lee, Chang-Rack</creatorcontrib><creatorcontrib>Jeon, Jin-Ho</creatorcontrib><creatorcontrib>Kim, Kyung-Ah</creatorcontrib><creatorcontrib>Bin, Seong-Il</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Dae-Hee</au><au>Lee, Chang-Rack</au><au>Jeon, Jin-Ho</au><au>Kim, Kyung-Ah</au><au>Bin, Seong-Il</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Graft Extrusion in Both the Coronal and Sagittal Planes Is Greater After Medial Compared With Lateral Meniscus Allograft Transplantation but Is Unrelated to Early Clinical Outcomes</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2015-01-01</date><risdate>2015</risdate><volume>43</volume><issue>1</issue><spage>213</spage><epage>219</epage><pages>213-219</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background: Graft extrusion after meniscus allograft transplantation (MAT) may be affected by horn fixation, which differs between medial and lateral MAT. Few studies have compared graft extrusion, especially sagittal extrusion, after medial and lateral MAT. Hypothesis: In patients undergoing medial and lateral MAT, graft extrusion is likely similar and not correlated with postoperative Lysholm scores. Study Design: Cohort study; Level of evidence, 2. Methods: Meniscus graft extrusion in the coronal and sagittal planes was compared in 51 knees undergoing medial MAT and 84 undergoing lateral MAT. Distances from the anterior and posterior articular cartilage margins to the anterior (anterior cartilage meniscus distance [ACMD]) and posterior (posterior cartilage meniscus distance [PCMD]) horns, respectively, were assessed on immediate postoperative magnetic resonance imaging and compared in patients undergoing medial and lateral MAT. Correlations between coronal and sagittal graft extrusion and between extrusion and the Lysholm score were compared in the 2 groups. Results: In the coronal plane, mean absolute (4.3 vs 2.7 mm, respectively; P &lt; .001) and relative (39% vs 21%, respectively; P &lt; .001) graft extrusions were significantly greater for medial than lateral MAT. In the sagittal plane, mean absolute and relative ACMD and PCMD values were significantly greater for medial than lateral MAT (P &lt; .001 each). For both medial and lateral MAT, mean absolute and relative ACMDs were significantly larger than PCMDs (P &lt; .001 each). Graft extrusion &gt;3 mm in the coronal plane was significantly more frequent in the medial (78%) than in the lateral (35%) MAT group. In the sagittal plane, the frequencies of ACMDs (72% vs 39%, respectively) and PCMDs (23% vs 4%, respectively) &gt;3 mm were also significantly greater in the medial than in the lateral MAT group. Coronal and sagittal extrusions were not correlated with postoperative Lysholm scores for both medial and lateral MAT. Conclusion: The amount and incidence of graft extrusion were greater after medial than lateral MAT in both the coronal and sagittal planes. In the sagittal plane, graft extrusion was greater and more frequent on the anterior than the posterior horn in both medial and lateral MAT. However, graft extrusion was not correlated with early clinical outcomes after both medial and lateral MAT.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>25389368</pmid><doi>10.1177/0363546514555699</doi><tpages>7</tpages></addata></record>
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subjects Adolescent
Adult
Allografts - pathology
Arthroplasty
Cartilage
Clinical outcomes
Correlation analysis
Female
Humans
Knee
Knee Joint - physiopathology
Longitudinal Studies
Lysholm Knee Score
Magnetic Resonance Imaging - methods
Male
Menisci, Tibial - pathology
Menisci, Tibial - transplantation
Middle Aged
NMR
Nuclear magnetic resonance
Postoperative Period
Prospective Studies
Sports medicine
Transplants & implants
Young Adult
title Graft Extrusion in Both the Coronal and Sagittal Planes Is Greater After Medial Compared With Lateral Meniscus Allograft Transplantation but Is Unrelated to Early Clinical Outcomes
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