PMID- 37597703 OWN - NLM STAT- MEDLINE DCOM- 20240319 LR - 20240319 IS - 1526-3231 (Electronic) IS - 0749-8063 (Linking) VI - 40 IP - 4 DP - 2024 Apr TI - Revision and Conversion to Arthroplasty Are Low Among Adolescents Undergoing Meniscal Allograft Transplantation Using the Bridge-In-Slot Technique at Midterm Follow-Up. PG - 1186-1194.e1 LID - S0749-8063(23)00662-X [pii] LID - 10.1016/j.arthro.2023.07.059 [doi] AB - PURPOSE: To report midterm outcomes after primary medial and lateral meniscal allograft transplantation (MAT) with fresh-frozen allografts implanted with the bridge-in-slot technique in the adolescent patient population. METHODS: Adolescent patients less than 18 years old at the time of primary MAT from 1999 to 2016 were retrospectively identified. International Knee Documentation Committee (IKDC) subjective form, Lysholm, and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales scores were collected before surgery and at 1-year, 2-year, and a minimum 5-year follow-up. Thresholds for achieving clinically significant outcomes were calculated, and the proportion of patients achieving minimal clinically important difference (MCID), patient-acceptable symptomatic state (PASS), and substantial clinical benefit (SCB) was determined. Meniscus reoperation (partial, subtotal, or total meniscectomy, repair, or failure) and failure (revision MAT or conversion to arthroplasty) rates were determined. RESULTS: Forty-four (female n = 33; male n = 11) of 62 identified patients met inclusion criteria and were followed for a mean of 9.5 +/- 3.8 years (range, 5.0-17.7). Lateral MAT was performed in most patients (n = 35/44 [80%]). Isolated MAT was performed in 27 (61%) patients. Common concomitant procedures included osteochondral allograft transplantation (32%), autologous chondrocyte implantation (18%), and anterior cruciate ligament reconstruction (14%). MCID, PASS, and SCB were achieved by patients at a minimum 5-year follow-up for IKDC (62%; 76%; 31%), Lysholm (62%; 79%; 23%), and KOOS questionnaires (Pain [65%; 81%; 41%], Symptoms [58%; 81%; 47%], Activities of Daily Living [53%; 77%; 35%], Sport [86%; 75%; 50%], and Quality of Life [59%; 81%; 59%]), respectively. Fourteen patients (32%) underwent reoperation at an average of 5.0 +/- 4.3 years (range, 0.8-14.0) after MAT. Three (7%) patients met criteria for failure, requiring revision MAT an average of 3.8 +/- 1.1 years (range, 2.8-4.9) after transplantation. No patients underwent arthroplasty. Overall survival free from failure at 1, 2, 5, and 10 years was 100%, 100%, 93%, and 93%, respectively. At the time of final follow-up, 80% of patients reported satisfaction with their current physical status. CONCLUSIONS: Primary MAT in adolescent patients resulted in significant and durable functional improvements at mid- to long-term follow-up. At an average of 9.5 years after surgery, meniscal reoperation rate was 32% whereas graft survival free of revision MAT was 93%. Adolescents undergoing MAT demonstrated similar functional outcomes and graft survivability when compared to available adult MAT literature. LEVEL OF EVIDENCE: Level IV, retrospective case series. CI - Copyright (c) 2023 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. FAU - Wagner, Kyle R AU - Wagner KR AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA. FAU - Kaiser, Joshua T AU - Kaiser JT AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA. FAU - Quigley, Ryan A AU - Quigley RA AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA. FAU - Hevesi, Mario AU - Hevesi M AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA. FAU - Damodar, Dhanur AU - Damodar D AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA. FAU - Meeker, Zachary D AU - Meeker ZD AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA. FAU - Cotter, Eric J AU - Cotter EJ AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA. FAU - Yanke, Adam B AU - Yanke AB AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA. FAU - Cole, Brian J AU - Cole BJ AD - Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA. Electronic address: Brian.cole@rushortho.com. LA - eng PT - Journal Article DEP - 20230818 PL - United States TA - Arthroscopy JT - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JID - 8506498 SB - IM MH - Adult MH - Humans MH - Adolescent MH - Female MH - Male MH - Retrospective Studies MH - Activities of Daily Living MH - Follow-Up Studies MH - Quality of Life MH - Arthroplasty MH - *Meniscus MH - *Anterior Cruciate Ligament Reconstruction MH - Menisci, Tibial/surgery MH - Allografts EDAT- 2023/08/20 00:41 MHDA- 2024/03/19 06:43 CRDT- 2023/08/19 19:25 PHST- 2022/12/21 00:00 [received] PHST- 2023/07/30 00:00 [revised] PHST- 2023/07/31 00:00 [accepted] PHST- 2024/03/19 06:43 [medline] PHST- 2023/08/20 00:41 [pubmed] PHST- 2023/08/19 19:25 [entrez] AID - S0749-8063(23)00662-X [pii] AID - 10.1016/j.arthro.2023.07.059 [doi] PST - ppublish SO - Arthroscopy. 2024 Apr;40(4):1186-1194.e1. doi: 10.1016/j.arthro.2023.07.059. Epub 2023 Aug 18.