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Meniscus Allograft Transplantation

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Sports Injuries

Abstract

Meniscal allotransplantation is considered a salvage procedure for symptomatic meniscal deficiency in a young patient. Although various contraindications have been described, including diffuse subchondral bone exposure, axial malalignment, and instability, a knee may be rendered suitable for meniscus transplantation if combined with chondral resurfacing, osteotomy, and/or ligament reconstruction. In the present manuscript, meniscus anatomy and function and exact preoperative size matching techniques are analyzed in detail. The most common arthroscopic methods involving double bone plug technique for medial meniscal transplantation, trough or “keyhole” techniques for lateral meniscal transplantation, and simultaneous anterior cruciate ligament reconstruction and meniscal transplantation are described. Possible complications after meniscus allotransplantation, surgical outcomes, and future directions are also discussed in this article.

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References

  1. Allen, C.R., Wong, E.K., Livesay, G.A., et al.: Importance of the medial meniscus in the anterior cruciate ligament-deficient knee. J. Orthop. Res. 18, 109–115 (2000)

    Article  PubMed  CAS  Google Scholar 

  2. Arnoczky, S.P., Warren, R.F.: Microvasculature of the human meniscus. Am. J. Sports Med. 10, 90–95 (1982)

    Article  PubMed  CAS  Google Scholar 

  3. Bos, G.D., Goldberg, V.M., Zika, J.M., et al.: Immune responses of rats to frozen bone allografts. J. Bone Joint Surg. Am. 65, 239–246 (1983)

    PubMed  CAS  Google Scholar 

  4. Buck, B.E., Resnick, L., Shah, S.M., et al.: Human immunodeficiency virus cultured from bone. Implications for transplantation. Clin. Orthop. Relat. Res. 251, 249–253 (1990)

    PubMed  Google Scholar 

  5. Cameron, J.C., Saha, S.: Meniscal allograft transplantation for unicompartmental arthritis of the knee. Clin. Orthop. Relat. Res. 337, 164–171 (1997)

    Article  PubMed  Google Scholar 

  6. Carpenter, J.E., Wojtys, E.M., Huston, L.J., et al.: Abstract: preoperative sizing of meniscal allografts. Arthroscopy 9, 344 (1993)

    Google Scholar 

  7. Carter, T.R.: Meniscal allograft: keyhole technique. Oper. Tech. Sports Med. 10, 144–149 (2002)

    Article  Google Scholar 

  8. Cole, B.J., Carter, T.R., Rodeo, S.A.: Allograft meniscal transplantation: background, techniques, and results. Instr. Course Lect. 52, 383–396 (2003)

    PubMed  Google Scholar 

  9. Day, B., Mackenzie, W.G., Shim, S.S., et al.: The vascular and nerve supply of the human meniscus. Arthroscopy 1, 58–62 (1985)

    Article  PubMed  CAS  Google Scholar 

  10. Garrett, J.C.: Meniscal transplantation: a review of 43 cases with 2 to 7 year follow-up. Sports Med. Arthrosc. Rev. 2, 164–167 (1993)

    Article  Google Scholar 

  11. Goble, E.M.: Arthroscopic meniscus transplantation: plug and slot technique. In: Miller, M., Cole, B.J. (eds.) Textbook of Arthroscopy, pp. 536–546. WB Saunders, Philadelphia (2004)

    Google Scholar 

  12. Goble, E.M., Kane, S.M.: Meniscal allografts. In: Czitrom, A.A., Winkler, H. (eds.) Orthopaedic Allograft Surgery, pp. 243–252. Springer, New York (1996)

    Chapter  Google Scholar 

  13. Goble, E.M., Kohn, D., Verdonk, R., et al.: Meniscal substitutes-human experience. Scand. J. Med. Sci. Sports 9, 146–157 (1999)

    Article  PubMed  CAS  Google Scholar 

  14. Hamlet, W., Lin, S.H., Yang, R.: Destruction of a cryopreserved rneniscal allograft: a case for acute rejection. Arthroscopy 13, 517–521 (1997)

    Article  PubMed  CAS  Google Scholar 

  15. Huang, A., Hull, M.L., Howell, S.M., et al.: Identification of cross sectional parameters of lateral meniscal allografts that predict tibial contact pressure in human cadaveric knees. J. Biomech. Eng. 124, 481–489 (2002)

    Article  PubMed  Google Scholar 

  16. Jackson, D.W., McDevitt, C.A., Simon, T.M., et al.: Meniscal transplantation using fresh and cryopreserved allografts: an experimental study in goats. Am. J. Sports Med. 20, 644–656 (1992)

    Article  PubMed  CAS  Google Scholar 

  17. Johnson, D.L., Swenson, T.M., Livesay, G.A., et al.: Insertion-site anatomy of the human menisci: gross, arthroscopic, and topographical anatomy as a basis for meniscal transplantation. Arthroscopy 11, 386–394 (1995)

    Article  PubMed  CAS  Google Scholar 

  18. Khoury, M.A., Goldberg, V.M., Stevenson, S.: Demonstration of HLA and ABH antigens in fresh and frozen human menisci by immunohistochemistry. J. Orthop. Res. 12, 751–757 (1994)

    Article  PubMed  CAS  Google Scholar 

  19. Klimkiewicz, J.J., Shaffer, B.: Data presented at the meeting of the AOSSM, Sun Valley (2000)

    Google Scholar 

  20. Klimkiewicz, J.J., Shaffer, B.: Meniscal surgery 2002 update: indications and techniques for resection, repair, regeneration, and replacement. Arthroscopy 18(9 Suppl 2), 14–25 (2002)

    Article  PubMed  Google Scholar 

  21. Levy, I.M., Torzilli, P.A., Warren, R.F.: The effect of medial meniscectomy on anterior-posterior motion of the knee. J. Bone Joint Surg. Am. 64, 883–888 (1982)

    PubMed  CAS  Google Scholar 

  22. MacConaill, M.A.: The function of intra-articular fibrocartilages, with special reference to the knee and inferior radiolunar joints. J. Anat. 66, 210–227 (1931)

    Google Scholar 

  23. Makris, C.A., Georgoulis, A.D., Papageorgiou, C.D., et al.: Posterior cruciate ligament architecture: evaluation under microsurgical dissection. Arthroscopy 16, 627–632 (2000)

    Article  PubMed  CAS  Google Scholar 

  24. McDevitt, C.A., Webber, R.J.: The ultrastructure and biochemistry of meniscal cartilage. Clin. Orthop. Relat. Res. 252, 8–18 (1990)

    PubMed  Google Scholar 

  25. Menetrey, J., Jones, D.G., Ernlund, L.S., et al.: Posterior peripheral sutures in meniscal allograft replacement. Arthroscopy 15, 663–668 (1999)

    Article  PubMed  CAS  Google Scholar 

  26. Mikic, Z.D., Brankov, M.Z., Tubic, M.V., et al.: Allograft meniscus transplantation in the dog. Acta Orthop. Scand. 64, 329–332 (1993)

    Article  PubMed  CAS  Google Scholar 

  27. Milachowski, K.A., Weismeier, K., Wirth, C.J.: Homologous meniscal transplantation: experimental and clinical results. Int. Orthop. 13, 1–11 (1989)

    Article  PubMed  CAS  Google Scholar 

  28. Noyes, F.R., Barber-Westin, S.D.: Irradiated meniscus allografts in the human knee: a two to five year follow-up. Orthop. Trans. 19, 417 (1989)

    Google Scholar 

  29. Packer, J.D., Rodeo, S.A.: Meniscal allograft transplantation. Clin. Sports Med. 28, 259–283 (2009)

    Article  PubMed  Google Scholar 

  30. Papageorgiou, C.D., Gil, J.E., Kanamori, A., et al.: The biomechanical interdependence between the anterior cruciate ligament replacement graft and the medial meniscus. Am. J. Sports Med. 29, 226–231 (2001)

    PubMed  CAS  Google Scholar 

  31. Peters, G., Wirth, C.J.: The current state of meniscal allograft transplantation and replacement. Knee 10, 19–31 (2003)

    Article  PubMed  Google Scholar 

  32. Pollard, M.E., Kang, Q., Berg, E.E.: Radiographic sizing for meniscal transplantation. Arthroscopy 11, 684–687 (1995)

    Article  PubMed  CAS  Google Scholar 

  33. Prodromos, C.C., Joyce, B.T., Keller, B.L., et al.: Magnetic resonance imaging measurement of the contralateral normal meniscus is a more accurate method of determining meniscal allograft size than radiographic measurement of the recipient tibial plateau. Arthroscopy 23, 1174–1179.e1 (2007)

    Article  PubMed  Google Scholar 

  34. Rath, E., Richmond, J.C., Yassir, W., et al.: Meniscal allograft transplantation. Two-to-eight year results. Am. J. Sports Med. 29, 410–414 (2001)

    PubMed  CAS  Google Scholar 

  35. Rijk, P.C.: Meniscal allograft transplantation – part I: background, results, graft selection and preservation, and surgical considerations. Arthroscopy 20, 728–743 (2004)

    Article  PubMed  Google Scholar 

  36. Rijk, P.C., Van Noorden, C.J.F.: Structural analysis of meniscal allografts after immediate and delayed transplantation in rabbits. Arthroscopy 18, 995–1001 (2002)

    Article  PubMed  Google Scholar 

  37. Rodeo, S.A.: Meniscal allografts – where do we stand? Am. J. Sports Med. 29, 246–261 (2001)

    PubMed  CAS  Google Scholar 

  38. Seedholm, B.B., Hargreaves, D.J.: Transmission of the load in the knee joint with special reference to the role of the menisci. Eng. J. Med. 8, 220–228 (1979)

    Article  Google Scholar 

  39. Sekaran, S.V., Hull, M.L., Howell, S.M.: Nonanatomic location of the posterior horn of a medial meniscus autograft implanted in a cadaveric knee adversely affects the pressure distribution on the tibial plateau. Am. J. Sports Med. 30, 74–82 (2002)

    PubMed  Google Scholar 

  40. Sekiya, J.K., Ellingson, C.I.: Meniscal allograft transplantation. J. Am. Acad. Orthop. Surg. 14, 164–174 (2006)

    PubMed  Google Scholar 

  41. Sekiya, J.K., Giffin, J.R., Irrgang, J.J., et al.: Clinical outcomes after combined meniscal allograft transplantation and anterior cruciate ligament reconstruction. Am. J. Sports Med. 31, 896–906 (2003)

    PubMed  Google Scholar 

  42. Sekiya, J.K., West, R.V., Groff, Y., et al.: Clinical outcomes following isolated lateral meniscal allograft transplantation. Arthroscopy 22, 771–780 (2006)

    Article  PubMed  Google Scholar 

  43. Shelton, W.R., Dukes, A.D.: Technical note – meniscal replacement with bone anchors: a surgical technique. Arthroscopy 10, 324–327 (1994)

    Article  PubMed  CAS  Google Scholar 

  44. Simon, W.H., Friedenberg, S., Richardson, S.: Joint congruence: a correlation of joint congruence and thickness of articular cartilage in dogs. J. Bone Joint Surg. Am. 55, 1614–1620 (1973)

    PubMed  CAS  Google Scholar 

  45. Stevenson, S.: The immune response to osteochondral allografts in dogs. J. Bone Joint Surg. Am. 69, 573–582 (1987)

    PubMed  CAS  Google Scholar 

  46. Stone, K.R., Rosenberg, T.D.: Technical note – surgical technique of meniscal replacement. Arthroscopy 9, 234–237 (1993)

    Article  PubMed  CAS  Google Scholar 

  47. Stone, K.R., Steadman, J.R., Rodkey, W.G., et al.: Regeneration of meniscal cartilage with use of a collagen scaffold. Analysis of preliminary data. J. Bone Joint Surg. Am. 79, 1770–1777 (1997)

    PubMed  CAS  Google Scholar 

  48. Thompson, W.O., Thaete, F.L., Fu, F.H., et al.: Tibial meniscal dynamics using three-dimensional reconstruction of magnetic resonance images. Am. J. Sports Med. 19, 210–216 (1991)

    Article  PubMed  CAS  Google Scholar 

  49. Voloshin, A.S., Wosk, J.: Shock absorption of meniscectomized and painful knees: a comparative in-vivo study. J. Biomed. Eng. 5, 157–161 (1983)

    Article  PubMed  CAS  Google Scholar 

  50. Walker, P.S., Erkman, M.J.: The role of the menisci in force transmission across the knee. Clin. Orthop. Relat. Res. 109, 184–192 (1975)

    Article  PubMed  Google Scholar 

  51. Watanabe, N., Woo, S.L., Papageorgiou, C., et al.: Fate of donor bone marrow cells in medial collateral ligament after simulated autologous transplantation. Microsc. Res. Tech. 58, 39–44 (2002)

    Article  PubMed  Google Scholar 

  52. Yoldas, E.A., Sekiya, J.K., Irrgang, J.J., et al.: Arthroscopically assisted meniscal allograft transplantation with and without combined anterior cruciate ligament reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 11, 173–182 (2003)

    PubMed  Google Scholar 

  53. Zimny, M.L., Albright, D.L., Dabeziew, E.: Mechanoreceptors in the human medial meniscus. Acta Anat. 133, 35–40 (1988)

    Article  PubMed  CAS  Google Scholar 

  54. Zukor, D.J., Cameron, J.C., Brooks, P.J., et al.: The fate of human meniscal allografts. In: Ewing, J.W. (ed.) Articular Cartilage and Knee Joint Function, pp. 147–152. Raven, New York (1990)

    Google Scholar 

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Correspondence to Christos D. Papageorgiou .

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Papageorgiou, C.D., Lykissas, M.G., Alaseirlis, D.A. (2012). Meniscus Allograft Transplantation. In: Doral, M. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-15630-4_42

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  • DOI: https://doi.org/10.1007/978-3-642-15630-4_42

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