Return to Sport and Patient Satisfaction After Meniscal Allograft Transplantation

• Published in: Arthroscopy Vol. 36; no. 9; pp. 2456 - 2463
• Main Authors: Cvetanovich, Gregory L., Christian, David R., Garcia, Grant H., Liu, Joseph N., Redondo, Michael L., Yanke, Adam B., Cole, Brian J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2020
• Subjects: Activities of Daily Living; Adult; Allografts; Anterior Cruciate Ligament Reconstruction; Arthroplasty, Replacement, Knee; Arthroscopy - methods; Female; Humans; Knee Joint - surgery; Male; Meniscectomy; Menisci, Tibial - transplantation; Middle Aged; Multivariate Analysis; Patient Reported Outcome Measures; Patient Satisfaction; Postoperative Period; Quality of Life; Reoperation - statistics & numerical data; Reproducibility of Results; Retrospective Studies; Return to Sport - statistics & numerical data; Transplantation, Homologous; Treatment Outcome; Young Adult
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2020.04.034

To investigate patient return to sport and satisfaction after meniscal allograft transplantation (MAT). Patients undergoing MAT using a bone bridge technique between 2013 and 2015 with minimum 2-year follow-up were retrospectively reviewed. They completed a survey regarding return to sport, satisfaction, and subsequent surgery in addition to patient-reported outcome measures. Of 117 patients, 87 (74.4%) were available at an average follow-up of 3.64 years (range, 2.01-5.13 years). The mean age at the time of surgery was 28.99 ± 8.26 years. Lateral MAT was performed in 44 cases (50.6%); medial MAT, 42 (48.3%); and combined medial and lateral MAT, 1 (1.1%). Concomitant procedures were performed in 72 patients (82.7%) including cartilage restoration (n = 65, 74.7%), realignment (n = 9, 10.3%), and anterior cruciate ligament reconstruction (n = 9, 10.3%). Patients experienced significant improvement in the Lysholm score (P < .001), International Knee Documentation Committee score (P < .001), Knee Injury and Osteoarthritis Outcome Score (KOOS)–Quality of Life (P < .001), KOOS–Activities of Daily Living (ADL) (P < .001), KOOS–Pain (P < .001), KOOS–Sports (P = .001), KOOS–Symptoms (P = .003), Short Form 12 physical score (P < .001), and Veterans Rand-12 physical score (P < .001). Reoperation was performed in 26 patients (29.9%); failure occurred in 12 patients (13.8%; total knee arthroplasty in 1, unicompartmental arthroplasty in 2, and total meniscectomy in 9). Overall, 77.0% of patients were satisfied with their outcome. Prior to MAT, 82 patients (94.3%) participated in sporting activities; 62 patients (75.6%) returned to at least one sport at 12.58 ± 6.20 months postoperatively, with 30 (48.4%) reaching their preoperative level of intensity and 72 (87.8%) discontinuing at least one of their preoperative sports. The most common reasons for sports discontinuation postoperatively were prevention of further damage (73.6%), pain with activity (51.4%), fear of further injury (48.6%), surgeon recommendation (33.3%), and swelling with activity (30.6%). Patients were satisfied with their sports participation at a rate of 62.1%. In a complex patient population undergoing arthroscopic MAT, 75.6% of patients were able to return to at least one sport at an average of 12.58 ± 6.20 months postoperatively. The level of sport declined, with 93.5% of patients restricting involvement to recreational sports after MAT and 48.4% returning to their preoperative level of activity intensity. In addition, 87.8% of patients reported discontinuing a sport in which they had participated preoperatively. The most common reasons for decreasing level of sport were prevention of further damage, pain or swelling with sports, and fear of further injury. The reoperation rate after MAT was 29.9%. Most patients were satisfied with the outcome of surgery, with 77.0% satisfied in general and 62.1% satisfied with their ability to play sports. Level IV, retrospective case series.