Early and Delayed Meniscal Shrinkage After Meniscal Allograft Transplantation: A Magnetic Resonance Imaging Study with a Minimum 3-year Follow-up
Author(s):
Lee B. (South Korea (ROK))
Lee B. (South Korea (ROK))
Affiliations:
ESSKA Academy. Lee B. 05/09/18; 209747; P14-274 Topic: Arthroscopic Surgery
Bum-Sik Lee
Bum-Sik Lee
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Abstract
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Objectives: It has never been determined whether meniscal allograft shrinkage occurs just during the early healing period or progresses over a mid-term delayed period and whether these meniscal deformations would affect the mid-term clinicoradiologic outcomes. In the present study, we estimated the amount of meniscal shrinkage during the first year of the early remodeling period and at the last MRI examination after more than 3 postoperative years. In addition, we determined if these changes were associated with clinical and radiological outcomes.

Methods: Sixty-seven patients (32 males and 35 females) with a mean age of 30.9 (range, 15-52) years who were followed up for 3 years or more with magnetic resonance imaging (MRI) after isolated lateral MATs were reviewed. The meniscal width of the transplants at the mid-body and posterior horn were measured on day 2 (as reference), at 1 year (after early remodeling period), and after at least 3 years (delayed period) after isolated lateral MAT. Joint space width was measured on 45° flexion posteroanterior views. The Lysholm score and Tegner activity scale were used to evaluate clinical outcomes.

Results: The mean relative meniscal width at the mid-body decreased to 93.6 ± 8.0% (P < .001) at 1 year postoperatively and to 88.0 ± 10.0% (P < .001) at the last follow-up of 4.0 ± 1.1 years. The posterior horn shrank less than the mid-body during the same period (96.0 ± 4.8% at 1 year [P < .001] and 92.5 ± 6.5% at last follow-up [P < .001]). Although there was no severe shrinkage (>50% of the initial size) in this cohort, the incidence of mild (10%-25%) and moderate (25%-50%) changes at the mid-body increased from 15 (22.4%) and 1 (1.5%) at 1 year to 33 (49.3%) and 5 (7.5%) at last follow-up, respectively. Posterior horn shrinkage was minimal (<10% reduction) in 60 (89.6%) and 47 (70.2%) patients at the 1-year and last MRI, respectively. The absolute and relative width changes did not significantly correlate with patient-reported outcomes or joint space width changes after 1 year or at last follow-up.

Conclusions: Shrinkage of fresh-frozen meniscal transplants occurs during both the early remodeling and delayed mid-term periods. Although the changes are greater in the mid-body than in the posterior horn, the overall changes are minimal and not associated with clinicoradiologic outcomes.

Keywords:
meniscus, allograft, shrinkage, magnetic resonance image
Objectives: It has never been determined whether meniscal allograft shrinkage occurs just during the early healing period or progresses over a mid-term delayed period and whether these meniscal deformations would affect the mid-term clinicoradiologic outcomes. In the present study, we estimated the amount of meniscal shrinkage during the first year of the early remodeling period and at the last MRI examination after more than 3 postoperative years. In addition, we determined if these changes were associated with clinical and radiological outcomes.

Methods: Sixty-seven patients (32 males and 35 females) with a mean age of 30.9 (range, 15-52) years who were followed up for 3 years or more with magnetic resonance imaging (MRI) after isolated lateral MATs were reviewed. The meniscal width of the transplants at the mid-body and posterior horn were measured on day 2 (as reference), at 1 year (after early remodeling period), and after at least 3 years (delayed period) after isolated lateral MAT. Joint space width was measured on 45° flexion posteroanterior views. The Lysholm score and Tegner activity scale were used to evaluate clinical outcomes.

Results: The mean relative meniscal width at the mid-body decreased to 93.6 ± 8.0% (P < .001) at 1 year postoperatively and to 88.0 ± 10.0% (P < .001) at the last follow-up of 4.0 ± 1.1 years. The posterior horn shrank less than the mid-body during the same period (96.0 ± 4.8% at 1 year [P < .001] and 92.5 ± 6.5% at last follow-up [P < .001]). Although there was no severe shrinkage (>50% of the initial size) in this cohort, the incidence of mild (10%-25%) and moderate (25%-50%) changes at the mid-body increased from 15 (22.4%) and 1 (1.5%) at 1 year to 33 (49.3%) and 5 (7.5%) at last follow-up, respectively. Posterior horn shrinkage was minimal (<10% reduction) in 60 (89.6%) and 47 (70.2%) patients at the 1-year and last MRI, respectively. The absolute and relative width changes did not significantly correlate with patient-reported outcomes or joint space width changes after 1 year or at last follow-up.

Conclusions: Shrinkage of fresh-frozen meniscal transplants occurs during both the early remodeling and delayed mid-term periods. Although the changes are greater in the mid-body than in the posterior horn, the overall changes are minimal and not associated with clinicoradiologic outcomes.

Keywords:
meniscus, allograft, shrinkage, magnetic resonance image
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