PMID- 38024091
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231201
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 11
DP  - 2023 Nov
TI  - Meniscal Allograft Transplantation Concomitant With Cartilage Repair for 
      Symptomatic Lateral Meniscus-Deficient Knees With Over Two Years of Follow-up.
PG  - e48774
LID - 10.7759/cureus.48774 [doi]
LID - e48774
AB  - Background and objective The treatment for symptomatic meniscus-deficient knees 
      with cartilage defects remains challenging on account of insufficient meniscal 
      substitutes. One solution for this might involve combining meniscal allograft 
      transplantation (MAT) and cartilage repair. In this study, we aimed to analyze 
      the effectiveness and safety of MAT concomitant with cartilage repair for 
      symptomatic lateral meniscus-deficient knees in a setting with limited 
      availability of meniscal transplants in Japan. Methods Nine patients who 
      underwent MAT concomitant with osteochondral transplantation (five) and/or 
      autologous chondrocyte implantations (seven) were followed up for at least two 
      years (mean: 51.2 months, range: 24-84 months). Their demographic data and other 
      characteristics were as follows - mean age: 51.7 years, range: 36-67 years; 
      men/women: 4/5; cause: trauma/discoid meniscus: 8/1; cartilage defect size: mean: 
      6.7 cm(2)/knee, range: 1.0-11.3. The effectiveness and safety were evaluated 
      clinically by using the Lysholm Knee Scoring Scale (LKSS) and Japanese 
      Orthopaedic Association (JOA) knee score, physical examination, X-rays, and MRI 
      preoperatively and at one, 12, and 24 months after the implantation. Differences 
      between the variables were analyzed using the Friedman test and Scheffe's 
      multiple comparisons. Results The median LKSS and JOA scores significantly 
      improved from 70 points (range: 21-80) and 35 (25-45) preoperatively to 86.5 
      (65-98) and 87.5 (80-95) at 24 months after surgery, respectively (p<0.001, 
      p=0.0013). The range of motion (ROM), femorotibial angle, and the lateral joint 
      space showed no significant changes. However, lateral meniscal extrusions (LMEs) 
      increased by 3.0 mm (range: 0-6.3 mm) at one month postoperatively and remained 
      unchanged until two years postoperatively. Treatment failure occurred in one 
      case, which was revised by total knee arthroplasty (TKA) at 18 months 
      postoperatively. Additional surgeries were needed in some cases: lateral meniscal 
      tear (three cases), contracture (two cases), and patellar instability (one case). 
      However, neither infection nor allergic reaction was observed in the blood exams. 
      Conclusions Although MAT concomitant with cartilage repair showed good clinical 
      outcomes, half of the cases needed additional surgeries. Based on our findings, 
      this technique should be adopted only in select cases and performed by a handful 
      of highly experienced surgeons.
CI  - Copyright (c) 2023, Uchio et al.
FAU - Uchio, Yuji
AU  - Uchio Y
AD  - Department of Orthopaedic Surgery, Shimane University, Izumo, JPN.
FAU - Takuwa, Hiroshi
AU  - Takuwa H
AD  - Department of Orthopaedic Surgery, Shimane University, Izumo, JPN.
FAU - Wakatsuki, Takuya
AU  - Wakatsuki T
AD  - Department of Orthopaedic Surgery, Shimane University, Izumo, JPN.
FAU - Kuwata, Suguru
AU  - Kuwata S
AD  - Department of Orthopaedic Surgery, National Hospital Organization Hamada Medical 
      Center, Hamada, JPN.
LA  - eng
PT  - Journal Article
DEP - 20231114
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10644150
OTO - NOTNLM
OT  - autologous chondrocyte transplantation
OT  - chondrocyte transplantation
OT  - lateral meniscus injury
OT  - meniscal allograft
OT  - meniscus-deficient knee
OT  - osteochondral transplantation
COIS- The authors have declared financial relationships, which are detailed in the next 
      section.
EDAT- 2023/11/29 18:43
MHDA- 2023/11/29 18:44
PMCR- 2023/11/14
CRDT- 2023/11/29 16:02
PHST- 2023/11/14 00:00 [accepted]
PHST- 2023/11/29 18:44 [medline]
PHST- 2023/11/29 18:43 [pubmed]
PHST- 2023/11/29 16:02 [entrez]
PHST- 2023/11/14 00:00 [pmc-release]
AID - 10.7759/cureus.48774 [doi]
PST - epublish
SO  - Cureus. 2023 Nov 14;15(11):e48774. doi: 10.7759/cureus.48774. eCollection 2023 
      Nov.