10-Year Survival and Clinical Improvement of Meniscal Allograft Transplantation in Early to Moderate Knee Osteoarthritis
Background: Meniscal allograft transplantation (MAT) is a viable option for patients experiencing unicompartmental knee pain after total or subtotal meniscectomy. Nonetheless, caution is recommended when suggesting this procedure in the presence of knee osteoarthritis (OA) because of the higher risk...
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| Veröffentlicht in: | The American journal of sports medicine 2024-07, Vol.52 (8), p.1997-2007 |
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| container_start_page | 1997 |
| container_title | The American journal of sports medicine |
| container_volume | 52 |
| creator | Romandini, Iacopo Grassi, Alberto Andrea Lucidi, Gian Filardo, Giuseppe Zaffagnini, Stefano |
| description | Background:
Meniscal allograft transplantation (MAT) is a viable option for patients experiencing unicompartmental knee pain after total or subtotal meniscectomy. Nonetheless, caution is recommended when suggesting this procedure in the presence of knee osteoarthritis (OA) because of the higher risk of poor survival and outcomes.
Purpose/Hypothesis:
The purpose was to document the long-term survival of MAT performed as a salvage procedure in patients with knee OA. The hypothesis was that MAT would significantly reduce pain and increase the function of the affected joint at a long-term follow-up compared with the preoperative condition, with a low number of failures and knee replacement surgeries.
Study Design:
Case series; Level of evidence, 4.
Methods:
A total of 47 patients (37 men and 10 women) with symptomatic knee OA (Kellgren-Lawrence grades 2 or 3) treated with MAT were evaluated at baseline, 5 years, and a minimum 10-year final follow-up (11.1 ± 1 years) using the Lysholm score, the visual analog scale for pain, the Knee injury and Osteoarthritis Outcome Score subscales, and the Tegner score. A total of 44 patients had undergone previous surgeries. Patient satisfaction, revision surgeries, and failures were also recorded.
Results:
A statistically significant improvement was observed in all clinical scores from the baseline assessment to the final follow-up. The Lysholm score improved significantly from 46.4 ± 17.2 at the preoperative assessment to 77.7 ± 20.4 at the intermediate follow-up (P < .001), with a significant decrease at the final follow-up (71 ± 23.3; P = .018). A similar trend was reported for the visual analog scale scale for pain, Knee injury and Osteoarthritis Outcome Score, and Tegner score, with no complete recovery to the previous sports activity level. A total of 33 patients required concurrent procedures, such as anterior cruciate ligament reconstructions, osteotomies, and cartilage procedures. Five patients underwent reoperation and were considered surgical failures, while 15 patients presented a clinical condition of |
| doi_str_mv | 10.1177/03635465241253849 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11264561</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_03635465241253849</sage_id><sourcerecordid>3083714393</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-b3df4aabe1bb5fbb50fe4a4049dab768482ca08723e2dab9766759cd79ccf62a3</originalsourceid><addsrcrecordid>eNp1kUtv1DAUhS0EokPhB7BBltiwSbHjR5IVqkYFKlp1QVmwsm6Sm6krxx5sZ0T_PR5NKS-xsCzf-91jHx9CXnJ2wnnTvGVCCyW1qiWvlWhl94isuFJ1JYRWj8lq36_2wBF5ltItY4w3un1KjkTbqoYJtiLfOau-IkT6eYk7uwNHwY907ay3Qzmcz9sYdjijzzRM9BK9Tfv6qXNhE2HK9DqCT1sHPkO2wVPr6RlEd0dzoJdhxAgZ6SePSK9SxgAx30SbbXpOnkzgEr6434_Jl_dn1-uP1cXVh_P16UU1SN7lqhfjJAF65H2vprLYhBIkk90IfTEj23oA1ja1wLpUukbrRnXD2HTDMOkaxDF5d9DdLv2M41CcRHBmG-0M8c4EsObPjrc3ZhN2hvNaS6V5UXhzrxDDtwVTNnP5BHTFM4YlGcG0FkLqri3o67_Q27BEX_wVqhUNl6ITheIHaoghpYjTw2s4M_tgzT_BlplXv9t4mPiZZAFODkCCDf669v-KPwAbEa1z</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3083714393</pqid></control><display><type>article</type><title>10-Year Survival and Clinical Improvement of Meniscal Allograft Transplantation in Early to Moderate Knee Osteoarthritis</title><source>SAGE Complete A-Z List</source><source>Alma/SFX Local Collection</source><creator>Romandini, Iacopo ; Grassi, Alberto ; Andrea Lucidi, Gian ; Filardo, Giuseppe ; Zaffagnini, Stefano</creator><creatorcontrib>Romandini, Iacopo ; Grassi, Alberto ; Andrea Lucidi, Gian ; Filardo, Giuseppe ; Zaffagnini, Stefano</creatorcontrib><description>Background:
Meniscal allograft transplantation (MAT) is a viable option for patients experiencing unicompartmental knee pain after total or subtotal meniscectomy. Nonetheless, caution is recommended when suggesting this procedure in the presence of knee osteoarthritis (OA) because of the higher risk of poor survival and outcomes.
Purpose/Hypothesis:
The purpose was to document the long-term survival of MAT performed as a salvage procedure in patients with knee OA. The hypothesis was that MAT would significantly reduce pain and increase the function of the affected joint at a long-term follow-up compared with the preoperative condition, with a low number of failures and knee replacement surgeries.
Study Design:
Case series; Level of evidence, 4.
Methods:
A total of 47 patients (37 men and 10 women) with symptomatic knee OA (Kellgren-Lawrence grades 2 or 3) treated with MAT were evaluated at baseline, 5 years, and a minimum 10-year final follow-up (11.1 ± 1 years) using the Lysholm score, the visual analog scale for pain, the Knee injury and Osteoarthritis Outcome Score subscales, and the Tegner score. A total of 44 patients had undergone previous surgeries. Patient satisfaction, revision surgeries, and failures were also recorded.
Results:
A statistically significant improvement was observed in all clinical scores from the baseline assessment to the final follow-up. The Lysholm score improved significantly from 46.4 ± 17.2 at the preoperative assessment to 77.7 ± 20.4 at the intermediate follow-up (P < .001), with a significant decrease at the final follow-up (71 ± 23.3; P = .018). A similar trend was reported for the visual analog scale scale for pain, Knee injury and Osteoarthritis Outcome Score, and Tegner score, with no complete recovery to the previous sports activity level. A total of 33 patients required concurrent procedures, such as anterior cruciate ligament reconstructions, osteotomies, and cartilage procedures. Five patients underwent reoperation and were considered surgical failures, while 15 patients presented a clinical condition of <65 of the Lysholm score and were considered clinical failures. Among these, 4 patients were considered both surgical and clinical failures.
Conclusion:
MAT surgery has proven to be a valid option for improving pain and function even in OA joints (Kellgren-Lawrence grades 2 or 3), yielding satisfactory results despite a worsening clinical outcome in the long-term follow-up. Therefore, based on the data from this study, orthopaedic surgeons may consider recommending MAT as a salvage procedure even in knees affected by early to moderate OA, while advising patients that the need for combined interventions could potentially reduce graft survival.</description><identifier>ISSN: 0363-5465</identifier><identifier>ISSN: 1552-3365</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/03635465241253849</identifier><identifier>PMID: 38857030</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Arthritis ; Hypotheses ; Knee ; Osteoarthritis ; Pain ; Patient satisfaction ; Surgery</subject><ispartof>The American journal of sports medicine, 2024-07, Vol.52 (8), p.1997-2007</ispartof><rights>2024 The Author(s)</rights><rights>2024 The Author(s) 2024 American Orthopaedic Society for Sports Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c419t-b3df4aabe1bb5fbb50fe4a4049dab768482ca08723e2dab9766759cd79ccf62a3</cites><orcidid>0000-0002-2376-3102</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/03635465241253849$$EPDF$$P50$$Gsage$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/03635465241253849$$EHTML$$P50$$Gsage$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38857030$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Romandini, Iacopo</creatorcontrib><creatorcontrib>Grassi, Alberto</creatorcontrib><creatorcontrib>Andrea Lucidi, Gian</creatorcontrib><creatorcontrib>Filardo, Giuseppe</creatorcontrib><creatorcontrib>Zaffagnini, Stefano</creatorcontrib><title>10-Year Survival and Clinical Improvement of Meniscal Allograft Transplantation in Early to Moderate Knee Osteoarthritis</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
Meniscal allograft transplantation (MAT) is a viable option for patients experiencing unicompartmental knee pain after total or subtotal meniscectomy. Nonetheless, caution is recommended when suggesting this procedure in the presence of knee osteoarthritis (OA) because of the higher risk of poor survival and outcomes.
Purpose/Hypothesis:
The purpose was to document the long-term survival of MAT performed as a salvage procedure in patients with knee OA. The hypothesis was that MAT would significantly reduce pain and increase the function of the affected joint at a long-term follow-up compared with the preoperative condition, with a low number of failures and knee replacement surgeries.
Study Design:
Case series; Level of evidence, 4.
Methods:
A total of 47 patients (37 men and 10 women) with symptomatic knee OA (Kellgren-Lawrence grades 2 or 3) treated with MAT were evaluated at baseline, 5 years, and a minimum 10-year final follow-up (11.1 ± 1 years) using the Lysholm score, the visual analog scale for pain, the Knee injury and Osteoarthritis Outcome Score subscales, and the Tegner score. A total of 44 patients had undergone previous surgeries. Patient satisfaction, revision surgeries, and failures were also recorded.
Results:
A statistically significant improvement was observed in all clinical scores from the baseline assessment to the final follow-up. The Lysholm score improved significantly from 46.4 ± 17.2 at the preoperative assessment to 77.7 ± 20.4 at the intermediate follow-up (P < .001), with a significant decrease at the final follow-up (71 ± 23.3; P = .018). A similar trend was reported for the visual analog scale scale for pain, Knee injury and Osteoarthritis Outcome Score, and Tegner score, with no complete recovery to the previous sports activity level. A total of 33 patients required concurrent procedures, such as anterior cruciate ligament reconstructions, osteotomies, and cartilage procedures. Five patients underwent reoperation and were considered surgical failures, while 15 patients presented a clinical condition of <65 of the Lysholm score and were considered clinical failures. Among these, 4 patients were considered both surgical and clinical failures.
Conclusion:
MAT surgery has proven to be a valid option for improving pain and function even in OA joints (Kellgren-Lawrence grades 2 or 3), yielding satisfactory results despite a worsening clinical outcome in the long-term follow-up. Therefore, based on the data from this study, orthopaedic surgeons may consider recommending MAT as a salvage procedure even in knees affected by early to moderate OA, while advising patients that the need for combined interventions could potentially reduce graft survival.</description><subject>Arthritis</subject><subject>Hypotheses</subject><subject>Knee</subject><subject>Osteoarthritis</subject><subject>Pain</subject><subject>Patient satisfaction</subject><subject>Surgery</subject><issn>0363-5465</issn><issn>1552-3365</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><recordid>eNp1kUtv1DAUhS0EokPhB7BBltiwSbHjR5IVqkYFKlp1QVmwsm6Sm6krxx5sZ0T_PR5NKS-xsCzf-91jHx9CXnJ2wnnTvGVCCyW1qiWvlWhl94isuFJ1JYRWj8lq36_2wBF5ltItY4w3un1KjkTbqoYJtiLfOau-IkT6eYk7uwNHwY907ay3Qzmcz9sYdjijzzRM9BK9Tfv6qXNhE2HK9DqCT1sHPkO2wVPr6RlEd0dzoJdhxAgZ6SePSK9SxgAx30SbbXpOnkzgEr6434_Jl_dn1-uP1cXVh_P16UU1SN7lqhfjJAF65H2vprLYhBIkk90IfTEj23oA1ja1wLpUukbrRnXD2HTDMOkaxDF5d9DdLv2M41CcRHBmG-0M8c4EsObPjrc3ZhN2hvNaS6V5UXhzrxDDtwVTNnP5BHTFM4YlGcG0FkLqri3o67_Q27BEX_wVqhUNl6ITheIHaoghpYjTw2s4M_tgzT_BlplXv9t4mPiZZAFODkCCDf669v-KPwAbEa1z</recordid><startdate>20240701</startdate><enddate>20240701</enddate><creator>Romandini, Iacopo</creator><creator>Grassi, Alberto</creator><creator>Andrea Lucidi, Gian</creator><creator>Filardo, Giuseppe</creator><creator>Zaffagnini, Stefano</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</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><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2376-3102</orcidid></search><sort><creationdate>20240701</creationdate><title>10-Year Survival and Clinical Improvement of Meniscal Allograft Transplantation in Early to Moderate Knee Osteoarthritis</title><author>Romandini, Iacopo ; Grassi, Alberto ; Andrea Lucidi, Gian ; Filardo, Giuseppe ; Zaffagnini, Stefano</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-b3df4aabe1bb5fbb50fe4a4049dab768482ca08723e2dab9766759cd79ccf62a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Arthritis</topic><topic>Hypotheses</topic><topic>Knee</topic><topic>Osteoarthritis</topic><topic>Pain</topic><topic>Patient satisfaction</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Romandini, Iacopo</creatorcontrib><creatorcontrib>Grassi, Alberto</creatorcontrib><creatorcontrib>Andrea Lucidi, Gian</creatorcontrib><creatorcontrib>Filardo, Giuseppe</creatorcontrib><creatorcontrib>Zaffagnini, Stefano</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Romandini, Iacopo</au><au>Grassi, Alberto</au><au>Andrea Lucidi, Gian</au><au>Filardo, Giuseppe</au><au>Zaffagnini, Stefano</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>10-Year Survival and Clinical Improvement of Meniscal Allograft Transplantation in Early to Moderate Knee Osteoarthritis</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2024-07-01</date><risdate>2024</risdate><volume>52</volume><issue>8</issue><spage>1997</spage><epage>2007</epage><pages>1997-2007</pages><issn>0363-5465</issn><issn>1552-3365</issn><eissn>1552-3365</eissn><abstract>Background:
Meniscal allograft transplantation (MAT) is a viable option for patients experiencing unicompartmental knee pain after total or subtotal meniscectomy. Nonetheless, caution is recommended when suggesting this procedure in the presence of knee osteoarthritis (OA) because of the higher risk of poor survival and outcomes.
Purpose/Hypothesis:
The purpose was to document the long-term survival of MAT performed as a salvage procedure in patients with knee OA. The hypothesis was that MAT would significantly reduce pain and increase the function of the affected joint at a long-term follow-up compared with the preoperative condition, with a low number of failures and knee replacement surgeries.
Study Design:
Case series; Level of evidence, 4.
Methods:
A total of 47 patients (37 men and 10 women) with symptomatic knee OA (Kellgren-Lawrence grades 2 or 3) treated with MAT were evaluated at baseline, 5 years, and a minimum 10-year final follow-up (11.1 ± 1 years) using the Lysholm score, the visual analog scale for pain, the Knee injury and Osteoarthritis Outcome Score subscales, and the Tegner score. A total of 44 patients had undergone previous surgeries. Patient satisfaction, revision surgeries, and failures were also recorded.
Results:
A statistically significant improvement was observed in all clinical scores from the baseline assessment to the final follow-up. The Lysholm score improved significantly from 46.4 ± 17.2 at the preoperative assessment to 77.7 ± 20.4 at the intermediate follow-up (P < .001), with a significant decrease at the final follow-up (71 ± 23.3; P = .018). A similar trend was reported for the visual analog scale scale for pain, Knee injury and Osteoarthritis Outcome Score, and Tegner score, with no complete recovery to the previous sports activity level. A total of 33 patients required concurrent procedures, such as anterior cruciate ligament reconstructions, osteotomies, and cartilage procedures. Five patients underwent reoperation and were considered surgical failures, while 15 patients presented a clinical condition of <65 of the Lysholm score and were considered clinical failures. Among these, 4 patients were considered both surgical and clinical failures.
Conclusion:
MAT surgery has proven to be a valid option for improving pain and function even in OA joints (Kellgren-Lawrence grades 2 or 3), yielding satisfactory results despite a worsening clinical outcome in the long-term follow-up. Therefore, based on the data from this study, orthopaedic surgeons may consider recommending MAT as a salvage procedure even in knees affected by early to moderate OA, while advising patients that the need for combined interventions could potentially reduce graft survival.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>38857030</pmid><doi>10.1177/03635465241253849</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-2376-3102</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0363-5465 |
| ispartof | The American journal of sports medicine, 2024-07, Vol.52 (8), p.1997-2007 |
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| source | SAGE Complete A-Z List; Alma/SFX Local Collection |
| subjects | Arthritis Hypotheses Knee Osteoarthritis Pain Patient satisfaction Surgery |
| title | 10-Year Survival and Clinical Improvement of Meniscal Allograft Transplantation in Early to Moderate Knee Osteoarthritis |
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