Mid-Term Clinical and Radiological Outcomes of Lateral Meniscal Allograft Transplantation with Suture-Only Fixation Plus Capsulodesis

 

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Abstract

Meniscal allograft transplantation (MAT) is an effective reconstructive procedure for treating a symptomatic postmeniscectomy syndrome. It consists of replacing the lost meniscal tissue aiming to improve the clinical outcomes and prevent progressive deterioration of the joint. The aim of this study was to evaluate meniscal graft survivorship and report on the radiographic (in terms of graft extrusion and joint space width and alignment) and the functional results through a midterm follow-up of lateral MAT performed with a soft tissue fixation technique after capsulodesis. In total, 23 patients who underwent lateral MAT as a single procedure were included. The Knee injury and Osteoarthritis Outcome Score, Lysholm, Tegner, and visual analog scale scales were used for patient assessment. Magnetic resonance imaging and a complete radiographic protocol were conducted to determine the degree of meniscal extrusion and the changes in the degree of osteoarthritis and coronal alignment. Assessments were performed after 2 and 7 years of follow-up. A significant improvement in all the scores, relative to preoperative values, was found after 7 years of follow-up. This improvement remained consistent throughout the first and second follow-up periods. A mean absolute extrusion of 2.2 mm ± 1.6 and an extrusion percentage of 28.0% ± 11.43 were found, with no significant differences throughout the follow-up periods. There was no statistically significant difference in terms of the frontal mechanical axis and joint space narrowing between the preoperative value and at the first and second follow-up periods. A survival rate of 85.7% was found after 7 years of follow-up. Capsulodesis results in a low degree of meniscal extrusion in isolated lateral MAT fixed with a suture-only technique, which is maintained after 7 years of follow-up, with a high graft survival index (>85%) and satisfactory results on the functional scales.

Ethical Approval

The present protocol was approved by the Institutional Review Board and the Research Ethics Committee of the Hospital Universitari Dexeus of the Universitat Autonoma de Barcelona with registration number: ExtMen 2016–01.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Consent to Publish

The authors affirm that human research participants provided informed consent for the publication of the images in [Fig. 1].

Availability of Data and Materials

All data are available for review.

Author Contributions

1. R.M.A.: was responsible for the conception of the research idea, protocol design and drafting, obtaining, analyzing and interpreting the data, drafting the manuscript and approval of its final version, as well as the agreement with the other authors that all doubts or aspects of the manuscript were meticulously reviewed before being sent to publication.

2. A.M.P.: was responsible for the conception of the research idea, protocol design and drafting, obtaining, analyzing and interpreting the data, drafting the manuscript, approval of the final version, search for current and ancient literature, as well as an agreement that all of the manuscript's minors were reviewed and it has validity and integrity.

3. J.R.P.M.: was responsible for the conception of the research question, acquisition and analysis of the data, writing of a part of the manuscript, and approval of its final version.

4. J.A.R.: was responsible for the conception of the research question, acquisition and analysis of the data, writing of a part of the manuscript, and approval of its final version.

5. M.I.: was responsible for the conception of the research question, acquisition and analysis of the data, contribution of knowledge in the area of statistics, writing of a part of the manuscript, and approval of its final version.

6. S.P.: was responsible for the design and conception of the study, realization of the translation and the statistical analysis, writing of part of the manuscript, search of the literature, analysis of the data and interpretation of them, and support of the final version of the manuscript.

7. C.A.A.: was responsible for the design and conception of the study, realization of the translation and the statistical analysis, writing of part of the manuscript, search of the literature, analysis of the data and interpretation of them, and support of the final version of the manuscript.

8. J.E.M.: made a substantial contribution to the manuscript from the orthopaedic point of view and was responsible for the proposal of the research idea, approval of the final version of the manuscript interpretation of the data, and supervision of the study.

9. J.C.M.: was one of the two main investigators of the study and an orthopaedic adviser and was responsible for the editing of the manuscript before its final version, proposal of the idea and clinical relevance of the study, implementation of the protocol methodology, interpretation of results, approval of the final version, and writing of part of the manuscript.

Publication History

Received: 16 June 2022

Accepted: 15 September 2022

Accepted Manuscript online:
19 September 2022

Article published online:
13 January 2023

© 2023. Thieme. All rights reserved.

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