Prospective comparative study between two different fixation techniques in meniscal allograft transplantation

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 21; no. 7; pp. 1516 - 1522
• Main Authors: Abat, Ferran, Gelber, Pablo Eduardo, Erquicia, Juan I., Tey, Marc, Gonzalez-Lucena, Gemma, Monllau, Juan Carlos
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.07.2013; Springer Nature B.V
• Subjects: Adolescent; Adult; Female; Follow-Up Studies; Humans; Hypotheses; Knee; Knee Joint - diagnostic imaging; Knee Joint - surgery; Male; Medicine; Medicine & Public Health; Menisci, Tibial - transplantation; Middle Aged; Orthopedics; Pain Measurement; Prospective Studies; Radiography; Recovery of Function; Surgeons; Surgery; Suture Techniques; Sutures; Transplantation, Homologous; Transplants & implants; Treatment Outcome; Bony fixation; Suture fixation; Meniscectomy; Meniscal allograft; Meniscal transplantation
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-012-2032-4

Purpose To compare the functional and radiographic results between two different horn fixation techniques for meniscal allograft transplant. Methods This is a prospective study of 88 meniscal allograft transplants with a mean 5-year follow-up. Forty transplants were performed on the medial compartment and 48 on the lateral compartment. The same surgeon performed all surgeries. Thirty-three grafts were fixed only with sutures (Group A) and 55 only with bony fixation (Group B). Both groups were comparable in terms of age, laterality, time since meniscectomy and preoperative functional and radiographic status. Functional assessment was done with Lysholm and Tegner scores and the Visual Analogical Scale for pain. Joint space narrowing was evaluated in the Rosenberg view. Results There was a significant improvement in Lysholm, Tegner and VAS scores without differences between Group A and Group B (n.s.). Radiographic evaluation did not show any joint space narrowing (n.s.). No differences in the comparison of all the variables of the two compartments were found. There were complications in 33.3 % of patients in Group A that including 7 graft tears (21.4 %) and in which there was an allograft failure rate of 9 %. Group B showed complications in 16.4 % of the patients and included 4 graft tears (7.3 %, n.s.) with an allograft failure rate of 3.6 %. Conclusions Meniscal allograft transplantation with either technique provided good functional and radiographic results at mid-term follow-up. Both graft fixation methods showed no differences relative to functional and radiographic results. There was a considerably higher rate of complications in transplantations performed with the only-suture technique than those with bony fixation, although the difference was not statistically significant with the numbers available. The results suggest that similar functional results should be expected whether the meniscal graft includes bone plugs or not. However, graft tears seem to happen more frequently if the MAT is performed without bony fixation. Level of evidence Prospective comparative study, Level II.