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Long-term Survivorship and Function of Meniscus Transplantation
- Source :
- The American Journal of Sports Medicine. 44:2330-2338
- Publication Year :
- 2016
- Publisher :
- SAGE Publications, 2016.
-
Abstract
- Background: Clinical outcomes and survivorship of meniscus transplants remain unclear, especially when magnetic resonance imaging (MRI) and weightbearing radiographic findings are included as endpoints. Many studies calculate survivorship based only on subsequent operative procedures. Purpose: We prospectively determined long-term survivorship and functional outcomes of 72 consecutive meniscus transplants. The effects of articular cartilage damage, concurrent osteochondral autograft transfer (20 knees), patient age, and tibiofemoral compartment were evaluated. Study Design: Case series; Level of evidence, 4. Methods: The long-term function and survival rates of 69 of 72 consecutive medial and lateral bone-meniscus-bone transplants (96% follow-up) were determined. Survival endpoints of reoperations, MRI failure (grade 3 signal intensity, extrusion >50% of meniscal width), meniscal tear on examination, and radiographic loss of joint space provided a worst-case outcome. Long-term functional analysis was performed in 58 transplants a mean of 11.9 ± 3.2 years postoperatively. The Cincinnati and International Knee Documentation Committee rating systems were used to evaluate outcomes. Results: For all transplants, the estimated probability of survival was 85% at 2 years, 77% at 5 years, 69% at 7 years, 45% at 10 years, and 19% at 15 years. There were significant improvements for pain, swelling, walking, stair climbing, and patient knee rating ( P < .05). Further surgery was performed in 37 cases. Knees that had concurrent osteochondral autograft transfer had significantly lower survival rates beginning at the seventh postoperative year; however, there was no significant difference in the long-term symptom, function, and patient perception scores between these knees and the rest of the cohort. The factors of articular cartilage damage (grade 2B/3 vs none), patient age (Conclusion: A survival analysis that includes reoperations, MRI, radiographs, and a comprehensive examination provides a worst-case but realistic analysis of transplant function. Many patients experienced a short- and long-term benefit of reduced symptoms and improved function. However, meniscus transplants undergo a deleterious remodeling process and eventually fail. Patients should be advised that the procedure is not curative in the long term, and additional surgery will likely be required.
- Subjects :
- Adult
Male
Long Term Survivorship
medicine.medical_specialty
Adolescent
Knee Joint
Radiography
Physical Therapy, Sports Therapy and Rehabilitation
Meniscus (anatomy)
Menisci, Tibial
Risk Assessment
Young Adult
03 medical and health sciences
0302 clinical medicine
Patient age
Survivorship curve
Humans
Medicine
Orthopedic Procedures
Orthopedics and Sports Medicine
Prospective Studies
Autografts
030222 orthopedics
medicine.diagnostic_test
business.industry
Magnetic resonance imaging
030229 sport sciences
Middle Aged
Articular cartilage damage
Surgery
Transplantation
Treatment Outcome
medicine.anatomical_structure
Patient Satisfaction
Female
Joint Diseases
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15523365 and 03635465
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- The American Journal of Sports Medicine
- Accession number :
- edsair.doi.dedup.....0179f82b937809b844df8e2435256c76