Meniscus Allograft Transplantation Obtained From Adult Patients Undergoing Total Knee Arthroplasty May be Used for Younger Patients After Lateral Discoid Meniscus Meniscectomy

Yuka Kimura; Yuji Yamamoto; Shizuka Sasaki; Eiji Sasaki; Tomoyuki Sasaki; Eiichi Tsuda; Yasuyuki Ishibashi

doi:10.1016/j.asmr.2021.07.024

Meniscus Allograft Transplantation Obtained From Adult Patients Undergoing Total Knee Arthroplasty May be Used for Younger Patients After Lateral Discoid Meniscus Meniscectomy

Arthrosc Sports Med Rehabil. 2021 Sep 10;3(6):e1679-e1685. doi: 10.1016/j.asmr.2021.07.024. eCollection 2021 Dec.

Authors

Yuka Kimura¹, Yuji Yamamoto¹, Shizuka Sasaki¹, Eiji Sasaki¹, Tomoyuki Sasaki^{1

2}, Eiichi Tsuda³, Yasuyuki Ishibashi¹

Affiliations

¹ Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
² Department of Orthopaedic Surgery, Hirosaki Memorial Hospital, Hirosaki, Japan.
³ Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

Abstract

Purpose: To investigate the clinical outcomes following meniscus allograft transplantation (MAT) to replace removed discoid lateral meniscus using intact lateral meniscus obtained from patients undergoing total knee arthroplasty for medial compartment osteoarthritis.

Methods: Pediatric patients who underwent MAT secondary to partial or total meniscectomy due to discoid lateral meniscus between August 2010 and November 2018 were identified. Lateral menisci with bone blocks were transplanted arthroscopically. The demographic data, range of motion, meniscal allograft failure, which was defined as removal of an implanted meniscus, and complications were recorded. The Lysholm score and the Kellgren-Lawrence (KL) grade on radiographs were evaluated preoperatively and at final follow-up. The Knee injury and Osteoarthritis Outcome Score was evaluated in the final follow-up.

Results: Eight patients who were symptomatic after discoid lateral meniscectomy were included. Donated allografts were harvested from adult patients aged between 64 and 78 years (mean 70.5 years). The mean age at previous meniscectomy and MAT were 10.5 and 18.1 years, respectively. All patients were followed up for a mean time of 5.2 years, and there were no cases of meniscus failure and complication. The Lysholm score significantly improved from preoperative to the final follow-up. Preoperatively, 6 and 2 knees were of KL grades II and III, respectively. At final follow-up, no increased KL grade was observed in 5 patients; however, an increase by 1 grade was observed in 2 patients and an increase by 2 grades was observed in 1 patient. The Knee injury and Osteoarthritis Outcome Scores at the final follow-up were 87.2 for pain, 87.9 for symptoms, 95.4 for activities of daily living, 79.4 for sports, and 65.6 for quality of life.

Conclusions: Older lateral meniscus allografts obtained from knees of adult patients undergoing total knee arthroplasty and transplanted into younger patients with defects from discoid lateral meniscectomy resulted in improved Lysholm scores but no improvement in Tegner scores or knee motion. KL grades were unchanged in 5 of the 8 patients at the final follow-up.

Level of evidence: IV, therapeutic case series.