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Medial Meniscus Allograft Transplantation with bone-bridge technique

Description

Objectives: Meniscal allograft transplantation (MAT) comprises an alternative surgical technique for patients with symptomatic meniscal deficiency. The aim of this study was to assess the mid-term clinical outcomes and safety profile of arthroscopic medial meniscus allograft transplantation (MMAT) using the bone-bridge technique
Methods: A prospective, single-center longitudinal study was performed including consecutive patients undergoing MMAT. Between 2014 and 2022, 17 patients (11 females) underwent MMAT with bone-bridge technique. The meniscal transplant was performed using a minimally-invasive arthroscopic technique. Internationally standardized and validated questionnaires (KOOS, IKDC, Lysholm, Tegner) and the VAS satisfaction score were assessed. Complication rates (failure of the graft, revision MMAT or conversion to arthroplasty) were recorded.
Results: Mean (±standard deviation [SD]) follow-up time was 4.2 (± 0.5) years. Mean (±SD) patient age was 32.7 (±11.5) years and mean BMI (±SD) was 24.2 (±4.1) kg/m . MMAT of the right knee was performed in 9 (53%) patients. Additional procedures were simultaneously with MMAT performed in 8 (47%) patients - autologous chondrocyte implantation (ACI): 4, medial tibial plateau autologous matrix-induced chondrogenesis (AMIC):2, lateral tibial plateau AMIC:1, lateral femoral condyle microfracture:1. Graft failure was recorded in 1 patient (6%), who underwent unicompartmental knee-replacement. At follow-up, significant post-operative improvements were observed in KOOS, IKDC, Lysholm, VAS for satisfaction and Tegner scores. There were no statistically significant differences in clinical outcomes between isolated MMAT and MMAT combined with other surgical procedures.
Conclusions: MMAT with bone-bridge technique offers a safe and effective option for addressing meniscal deficiency and salvage of the postmeniscectomized knee. The significant success rates and mid-term patient satisfaction of this innovative technique, in conjunction with its excellent safety profile create clinical equipoise for wider clinical application.

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Author

I F

Ilias Fanourgiakis

International Center for Orthopedics, ATOS Clinic, Heidelberg, Germany

T B

Theodore Balfousias

International Center for Orthopedics, ATOS Clinic, Heidelberg, Germany

R S

Rainer Siebold

International Center for Orthopedics, ATOS Clinic, Heidelberg, Germany

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