Patient-reported outcome and survival following meniscal allograft transplantation: an international case series. (1st June 2022)

• Record Type: Journal Article
• Authors: Barlow, Timothy; Coco, Vito; Shivji, Faiz; Grassi, Alberto; Asplin, Laura; Thompson, Peter; Metcalfe, Andrew; Zaffagnini, Stefano; Spalding, Tim
• Is Part Of: Bone & joint journal. Volume 104B:Number 6(2022)
• Page Start: 657
• Page End: 662
• Publication Date: 2022-06-01
• Subjects: Meniscal transplant -- patient-reported outcome measures (PROMs) -- meniscal allograft transplantation -- Knee injury and Osteoarthritis Outcome Score (KOOS) -- functional outcome scores -- tibia -- cartilage lesions -- femur -- BMI -- Cox proportional hazards models -- arthritis; Bones -- Surgery -- Periodicals; Joints -- Surgery -- Periodicals; Orthopedic surgery -- Periodicals; 617.47005
• DOI: 10.1302/0301-620X.104B6.BJJ-2021-0944.R2
• Languages: English
• ISSNs: 2049-4394

Abstract

Abstract : Aims: Meniscal allograft transplantation (MAT) for patients with symptomatic meniscal loss has demonstrated good clinical results and survivorship. Factors that affect both functional outcome and survivorship have been reported in the literature. These are typically single-centre case series with relatively small numbers and conflicting results. Our aim was to describe an international, two-centre case series, and identify factors that affect both functional outcome and survival. Methods: We report factors that affect outcome on 526 patients undergoing MAT across two sites (one in the UK and one in Italy). Outcomes of interest were the Knee injury and Osteoarthritis Outcome Score four (KOOS4) at two years and failure rates. We performed multiple regression analysis to examine for factors affecting KOOS, and Cox proportional hazards models for survivorship. Results: Our results indicate that baseline KOOS4 score affects functional outcome at two years, but no other included factors were significantly related to functional outcome. The only factor that affected failure rate was the presence of cartilage lesions down to bone on both the femur and tibia, decreasing the five-year survivorship from 95% (95% confidence interval (CI) 91 to 99) to 84% (95% CI 74 to 94). Conclusion: To our knowledge, this is the largest international cohort reporting on MAT. Our results indicate that factors such as age, BMI, and cartilage lesions down to bone on both the femur and tibia of the affected compartment should not present barriers to offering MAT. Baseline KOOS4 score and the presence of bone-on-bone arthritis can be used to help counsel patients regarding the expected risks and rewards of surgery. Cite this article: Bone Joint J 2022;104-B(6):657–662.