2023 ISAKOS Biennial Congress ePoster
Clinical Outcomes of Meniscal Allograft Transplantation: Does Augmentation with Bone Marrow Aspirate Concentrate Improve Clinical Outcomes?
Ryan M Bell, BS, Hartford, CT UNITED STATES
Julie P Burland, PhD, Storrs, CT UNITED STATES
Paige Holden, BS, Farmington, CT UNITED STATES
Mark P. Cote, PT, DPT, MSCTR, Farmington, CT UNITED STATES
Katherine June Coyner, MD, MBA, Farmington, CT UNITED STATES
Robert A. Arciero, MD, Farmington, CT UNITED STATES
Cory M. Edgar, MD, PhD, Farmington, CT UNITED STATES
University of Connecticut Musculoskeletal Institute, Farmington, CT, UNITED STATES
FDA Status Not Applicable
Summary
Biological augmentation of meniscus allograft transplants, a salvage procedure with generally poor clinical outcomes, does not significantly improve clinical outcomes, but may offer modest improvements in reoperation and failure rates.
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Abstract
Background
Meniscal tears are a common orthopedic injury that are generally treated with a partial meniscectomy, which often requires revision, which can increase meniscal tissue loss. Significant meniscal tissue loss can disrupt native knee joint kinematics and predispose patients to excessive chondral wear and osteoarthritis. Meniscus allograft transplantation (MAT) is a salvage procedure designed to reduce symptoms and slow progression of osteoarthritis in patients with significant meniscus tissue loss, however there is a high rate of failure and generally poor clinical outcomes. In an effort to improve regenerative capacity and clinical outcomes, augmentation with Bone Marrow Aspirate Concentrate (BMAC) was identified as a potential augmentative strategy due to the benefit it has shown in various other orthopedic procedures.
Methods
In this study, the authors examined the impact of BMAC augmentation on clinical outcomes for patients undergoing a MAT. Perceived and functional outcomes were compared amongst a cohort of 28 patients who underwent a MAT with and without BMAC augmentation. Patient reported clinical outcomes were obtained via survey including the International Knee Documentation Committee (IKDC) subjective score, Marx Activity score, Lysholm-Tegner score, SANE score, and Global Rating of Change (GRoC) score.
Results
Overall reoperation rate rate was 41%, 28.6% in BMAC augmented MAT, and 50% in non-augmented MAT. Overall failure rate was 20.7%, 14.3% in BMAC augmented and 22.3% in non-augmented MAT. Differences between BMAC augmented and non-augmented MAT patient reported outcome score surveys were not statistically significant.
Conclusions
BMAC augmentation of MAT, compared to non-augmented MAT, did not significantly improve clinical outcomes, but may offer modest improvement in reoperation and failure rates.