BACKGROUND:
The purpose of this study was to prospectively evaluate the results of
meniscal transplantation in a consecutive series of younger patients treated
for pain in the tibiofemoral compartment following a previous
meniscectomy.
METHODS:
Forty cryopreserved menisci were implanted into thirty-eight patients.
Sixteen knees also had an osteochondral autograft transfer, and nine had a
knee ligament reconstruction. The clinical outcome and failure rate of all
transplants were evaluated at a mean of forty months postoperatively. Meniscal
allograft characteristics were determined with use of a rating system that
combined subjective, clinical, and magnetic resonance imaging factors.
RESULTS:
Thirty-four (89%) of the thirty-eight patients rated the
knee condition as improved. Before surgery, thirty patients (79%) had pain
with daily activities, but only four (11%) had such pain at the time of the
latest follow-up. While noteworthy pain was present in the tibiofemoral
compartment in all forty knees before surgery, twenty-seven knees (68%) had no
pain and thirteen (33%) had only mild compartment pain at the time of the
latest follow-up. Twenty-nine patients (76%) returned to light low-impact
sports without problems. Concomitant osteochondral autograft transfer and knee
ligament reconstruction procedures improved knee function and did not increase
the rate of complications. Meniscal allograft characteristics were normal in
seventeen knees (43%), altered in twelve (30%), and failed in eleven
(28%).
CONCLUSIONS:
The short-term results of meniscal transplantation are encouraging in terms
of reducing knee pain and increasing function; however, long-term transplant
function and any chondroprotective effects remain unknown and require further
investigation.