Summary

the bone trough technique meniscal allograft transplantation is the known and first choice for lateral meniscal allograft transplantation with better bone healing and less complications. in this paper we reported the clinical outcome of the Novel bone trough technique for medial meniscal allograft transplantation with less rate of complications.

Abstract

Purpose

Restoring knee functionality and decreasing the risk of osteoarthritis are paramount following meniscus allograft transplantation (MAT). Three fixation techniques (soft-tissue, bone plug, and the bone trough technique) have been employed for this procedure. For lateral meniscus allograft transplantation (LMAT), the bone trough technique has proven superior. The purpose of this surgical technique description was to describe our method of medial meniscus allograft transplantation (MMAT) using the bone trough technique, while simultaneously evaluating patient outcomes before and after the procedure.

Methods

13 patients (mean age, 34.12 ± 8.86; 8 female and 5 male) undergoing a MMAT were evaluated using clinical surveys to determine functional outcomes. Evaluation was achieved using three surveys: Western Ontario and McMaster Osteoarthritis Index (WOMAC), International Knee Documentation Committee (IKDC), and the Tegner Lysholm Knee Scoring Scale (Lysholm) evaluated before MMAT and at final follow-up.

Results

Comparison of each survey at time point one (prior to MMAT) and time point two (at final follow-up) revealed improvement in functional outcomes using the WOMAC, IKDC, and Lysholm surveys (P < 0.001). Functional outcomes based on the WOMAC survey improved from 59.31 ± 14.58 prior to MMAT to 9.77 ± 6.29 at final follow-up (83% improvement). Functional outcomes based on the IKDC survey improved from 42.62 ± 7.33 prior to MMAT to 63.54 ± 7.63 at final follow-up (49% improvement). Functional outcomes based on the Lysholm survey improved from 27.62 ± 15.38 prior to MMAT to 86.62 ± 13.02 at final follow-up (400% improvement).

Conclusion

Based on the considerable improvement using three separate clinical surveys for evaluating functional outcomes of the knee after a surgical procedure, the bone trough technique for MMAT is a reasonable procedure. Using the bone trough technique was no associated with any major complication or graft failure.


Result

Medial Meniscus Allograft Transplantation Using Bone Trough Technique (n=13)
Knee Scoring Scale Preoperative Follow-up % Change P
WOMAC 59.31 ± 14.58 9.77 ± 6.29 83.5 <0.001
IKDC 42.62 ± 7.33 63.54 ± 7.63 49.1 <0.001
Lysholm 27.62 ± 15.38 86.62 ± 13.02 414 <0.001

The group receiving medial meniscal allograft transplants was comprised of thirteen patients, with a mean age of 34.12 (range: 22.22-50.48) and BMI of 25.25 (range: 20.50 – 32.00), five males, and eight females, with a mean follow up time of 85 months. One male in this group was not an athlete (8%). Six patients in this group had previous surgeries (prior meniscal transplant, prior ACL reconstruction, prior repair of defect of medial femoral condyle, chondroplasty) on their affected knee with the following complications: pain, MRSA infection, posttraumatic osteoarthritis.
Thirteen medial meniscus allograft transplants were performed using the bone trough technique. Outcomes of this procedure were evaluated using three different knee scoring scales: WOMAC, IKDC, and Lysholm.
There were statistically significant improvements in all three knee scoring scales. The mean WOMAC score showed significant improvement from 59.31 ± 14.58 during the preoperative stage to 9.77 ± 6.29 at follow-up. The mean IKDC score showed significant improvement from 42.62 ± 7.33 during the preoperative stage to 63.54 ± 7.63 at follow-up. The mean Lysholm score showed significant improvement from 27.62 ± 15.38 during the preoperative stage to 86.62 ± 13.02 at follow-up.