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Meniscal allograft transplantation for symptomatic meniscal defect. Minimum 10-years follow-up.
Author(s):
Torres-Claramunt R. (Spanien)
Torres-Claramunt R. (Spanien)
Affiliations:
ESSKA Academy. Torres-Claramunt R. 05/09/18; 209764; P14-1573 Topic: Arthroscopic Surgery
Dr. Raúl Torres-Claramunt
Dr. Raúl Torres-Claramunt
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Abstract
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Objectives: Post-meniscectomy syndrome (PMS) is defined as pain occuring in a previously meniscectomized knee compartment. Although several treatments can be considered, the etiologic approach seems to be the restitution of the lost meniscal tissue. This can be accomplished with a meniscal allograft transplantation (MAT) when the meniscus defect is complete.
The aim of this study is to review the clinical and radiological evolution of patients underwent a MAT for a symptomatic complete meniscal defect with a minimum 10-years follow-up.

Methods: It was included all consecutive patients that were operated on either persistent medial or lateral joint line compartmental pain receiving an MAT due to a previous complete meniscus resection with a minimum 10-years of follow-up. Functional scores (EVA, Lysholm and Tegner) were assessed preoperatively, at 5-years after the surgery and at the last follow-up. The state of the meniscal tissue as well as the postoperative extrusion was also evaluated with MRI.
The results were statistically analysed and compared using a Student t-test for parametric data with normal distribution. The level of significance was set at < 0.05.

Results: Thirty-two patients were initially included in the study with a mean age of 36.3 (SD 8.4) years old. The mean BMI was 25.4 (SD3.2). All patients suffered 1.8 (SD0.3) surgeries previous to the MAT and most of the surgeries were performed on the medial meniscus (19/32). Lysholm score improves from 64.4(SD10.3) preoperatively to 87.4(SD 8.1) at 5-years and 75.4(SD11.3) at final follow-up (p=0.00). Tegner score improves from 3.16(1.8) preoperatively to 5.2(SD1.9) at 5-years and 3.84(SD1.3) at final follow-up (p=0.00). EVA score also improves from 6.5(SD1.8) preoperatively to 1.3(SD1.3) at 5-years and 2.44(SD1.7) at final follow-up.
Nineteen out of 32 patients acceded to do an MRI at last follow-up. Five out of these 19 patients presented a complete meniscal resorbption. The other patients presented an extrusion of 57%(SD3.5). This extrusion at 5-years of follow-up was 28.9%(SD2.5) (p=0.00).

Conclusions: -MAT improves the knee functionality at 5-years and 10-years follow-up. However these results are better at 5-years with regard on the final follow-up outcomes.
-Meniscal status at final follow-up showed a resorbption of the meniscal tissue and an increased extrusion.

Keywords:
Meniscus, MAT, transplatation, allograft, knee
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