Results and Indications

Abstract

The aim of the present review of meniscal allograft transplantation during the last 24 years, is to put this procedure into a clinical perspective. Meniscal allograft transplantation has emerged as a useful treatment for carefully selected patients. Almost all studies, from short- to long-term (>10 years of follow-up), report patient satisfaction and improvement in pain and function. Objectively, physical examination findings are improved in the majority of patients. Radiologically, joint space narrowing is only significantly progressive at long-term follow-up. On magnetic resonance imaging (MRI), shrinkage is seen after some years, but more in lyophilized allografts. Histologically, incomplete repopulation of the graft is noticed. Second-look arthroscopy usually shows good healing to the capsule. In a recent long-term study, progression of cartilage degeneration according to MRI and radiological criteria was halted in a number of patients, indicating a chondroprotective effect. However, there still is a lack of consensus on how the success of a meniscal transplantation should be evaluated, which makes it difficult to compare study outcomes. In our opinion, radiographic measurement of joint space narrowing and changes in meniscal allograft MR signal are the best assessment tools, but the use of a good clinical evaluation system, such as the International Knee Documentation Committee (IKDC) and the Hospital for Special Surgery (HSS) scoring system, remains essential.