Prospective Evaluation Of Meniscal Allograft Transplantation Revision: A Minimum Of 2-year Follow-up

IntroductionWhile the outcomes of primary meniscal allograft transplantation (MAT) have been widely reported, the results of revision MAT have not been described. The purpose of this study is to assess the clinical and radiographic outcomes following revision MAT. We hypothesized that revision MAT procedure is a viable option for the young, active patient with signs and symptoms of a failed MAT.MethodsConsecutive patients who underwent revision MAT by the primary author were prospectively studied. Each completed standardized outcome surveys (including International Knee Documentation Committee, Cincinnati Knee-Rating System, Tegner score, Lysholm score, Short Form–12 scales, Knee Injury and Osteoarthritis Outcome Score, and overall satisfaction) preoperatively and annually thereafter for a minimum of 2-year follow-up. Radiographic analysis before surgery and at the most recent follow-up included anteroposterior, Rosenberg, lateral, and sunrise views graded by the Kellgren and Lawrence scale. The status of the articular cartilage was graded intraoperatively using the Outerbridge classification. Two patients were lost to follow-up and one declined further participation.ResultsEleven patients met inclusion criteria, of which three were lost to follow up. The remaining (3 males, 5 females) had a mean age of 31.6±10.2 years, with five lateral and three medial menisci involved. The average time to revision MAT from the index procedure was 3.45±2.52 years with a mean follow up after RMAT of 3.8±1.3 years. One patient progressed to arthroplasty during follow-up. Clinical outcome scores did not demonstrate improvement at follow-up; however, subjective symptom rate significantly improved from 5.0±0.9 pre-operatively to 6.7±1.8 post-operatively (p=0.011). Radiographic (p=0.7) and Outerbridge (p=0.809) grading did not demonstrate progression. Seven of eight patients would have surgery again and satisfaction at final follow-up was 7.6±2.6 (of a possible maximum 10 points).ConclusionWhile revision MAT did not demonstrate improvement in clinical outcome scores, symptom rate significantly improved. Similarly, objective findings of radiographic progression was not detected. Most patients were completely or mostly satisfied and 7 of 8 would have surgery again. IntroductionWhile the outcomes of primary meniscal allograft transplantation (MAT) have been widely reported, the results of revision MAT have not been described. The purpose of this study is to assess the clinical and radiographic outcomes following revision MAT. We hypothesized that revision MAT procedure is a viable option for the young, active patient with signs and symptoms of a failed MAT.