CHICAGO — Patients who undergo meniscal allograft transplantation had high patient satisfaction and improvement in function, according to results presented here at the International Cartilage Repair Society Annual Meeting.
“Where the joint surface is preserved then we have a low failure rate of 1.6%, but we have a higher failure rate where the surface is more damaged,” Timothy Spalding, MD, said. “But especially where it is bare bone on both surfaces, we still have two-thirds with a good result. Then we look at the patient-reported outcome measures in those groups and they are all significantly improved and similar out to the 3-year point.”
Spalding and colleagues prospectively analyzed patients undergoing 114 meniscal allograft transplantations since 2005 and collected operative and demographic data, as well as patient-reported outcome measures. Patients were allocated to group 1 if they had articular cartilage surfaces ICRS grade 1-3a; to group 2 if they had surfaces grade 3b or greater on one surface and had repair procedures; and group 3 if they had grade 3b or greater on both surfaces.
Results showed a mean time from meniscectomy to meniscal allograft transplantation of 9.3 years, which significantly correlated to chondral surface. In a mean time of 25 months, 10.5% of patients had overall graft failure, with one graft failing in group 1, two grafts failing in group 2 and nine grafts failing in group 3.
Researchers found 75% of graft failures and tears from one particular tissue bank. No significant difference was found between groups when grafts survived the change in patient-reported outcome measures.
“Our ideal patient still remains the patient with the preserved articular cartilage. That is the group we want to focus on and get them presenting earlier for the surgery,” Spalding said. “There still is a role left for advanced cartilage damage to form in meniscal joints, but we have to select our patients’ right and warn them that we have had a one-third failure in that group.” – by Casey Tingle
Spalding T, et al. Meniscal allograft transplantation: Analysis of outcome based on articular cartilage status in 114 consecutive cases. Presented at: International Cartilage Repair Society Annual Meeting. May 8-11, 2015; Chicago.
Disclosure: Spalding reports no relevant financial disclosures.