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Early functional outcomes of lateral meniscal allograft transplantation from meniscus preserved from total knee arthroplasty
ESSKA Academy. Goyal T. Nov 8, 2019; 285953; epEKA-73 Topic: Open Surgery
Dr. Tarun Goyal
Dr. Tarun Goyal
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Abstract
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Introduction: Lateral meniscus preserved from knees undergoing total knee arthroplasty for medial compartment osteoarthritis and a healthy lateral compartment was used in 20 patients undergoing meniscus transplantation. Functional outcomes at 6 months are presented.
Methods: Patients aged 18-45 years with an irreparable tear of lateral meniscus were included. Lateral meniscus was harvested from patients lesser than 65 years of age, undergoing total knee replacement for osteoarthritis of medial compartment. Lateral compartment and lateral meniscus was normal clinically and on pre-operative magnetic resonance imaging. Meniscal repair was done using two bony tunnels for fixation of meniscus graft with a bone plug anteriorly and posteriorly. Peripherally graft was secured with 6-8 sutures using inside-out technique. Frozen allografts were used. Failure was defined as locking or graft tear on magnetic resonance imaging performed at 6 months. Lysholm scores were recorded 6 months after the surgery.
Results: No patient required revision surgery for pain, locking or meniscal tear. Mean Lysholm scores improved from 68±4.2 to 89±5.4, p value < 0.05. Meniscus extrusion of more than 3 mm was seen in 6 patients, but none of these patients had symptoms of failure. Visual analogue score for pain improved from 4.3±1.9 to 1.6±0.8, p value < 0.05.
Conclusion: Lateral meniscus is salvageable in many patients with medial compartmental osteoarthritis and its availability is easier compared to cadaveric allografts. Early clinical and radiological outcomes are encouraging and a longer follow-up of these patients will be available with time.
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