2023 ISAKOS Biennial Congress In-Person Poster
Anatomical Survival of the Graft After Medial Meniscal Allograft Transplantation is Better in Patients with Lower-Grade ICRS Lesions: MRI-Based Objective Evaluation
Seong-Il Bin, MD, PhD, Seoul KOREA, REPUBLIC OF
Jong-Min Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Bum-Sik Lee, MD, Seoul KOREA, REPUBLIC OF
seonjong Lee, MD, Seoul KOREA, REPUBLIC OF
Ju-Ho Song, MD KOREA, REPUBLIC OF
Ho Yeon Kim, MD, Yongin-Si, Gyeonggi-do KOREA, REPUBLIC OF
Jaejung Ryu, MD, Seoul KOREA, REPUBLIC OF
University of Ulsan, College of Medicine, Asan Medical Center, Seoul , KOREA, REPUBLIC OF
FDA Status Not Applicable
Summary
Low-grade ICRS lesion is associated with higher anatomical survival rate after medial MAT.
Abstract
Background
There is a lack of data regarding the survival rate following medial meniscus allograft (MAT) alone. Furthermore, there is little information about prognostic factors for graft survival that impact the outcomes of medial MAT.
Purpose
To investigate the prognostic factors and survival rate of allograft after medial MAT.
Methods
The records of 78 consecutive patients who underwent primary medial MAT between 1996 and 2018 were reviewed. Kaplan-Meier survival analysis was performed to analyze the anatomical and clinical survival rates. Anatomical failure was defined as a tear covering more than 50% of the allograft or unstable peripheral rim. Clinical failure was considered Lysholm score <65 or need for additional surgery such as meniscal repair, revision MAT, realignment osteotomy, and meniscectomy for more than 50% of the allograft. Patient factors affecting anatomical and clinical failure were analyzed.
Results
The mean follow-up period was 6.9±5.3 years (range, 2-21 years). Anatomical failure was noted in 19 patients (24.4%) and none of these patients had a persistent poor Lysholm score of <65; of these, 2 patients who underwent meniscal repair also had clinical failure. Clinical failure was noted in 7 patients (9.0%); 4 patients had Lysholm score <65, 2 patients underwent meniscal repair, and 1 patient underwent realignment osteotomy. The estimated 10-year anatomical and clinical survival rates were 73.89% and 87.90%, respectively. Anatomical survival was significantly affected only by high-grade ICRS lesion (ICRS grade 3 or 4) (HR=3.171, 95% CI=1.124-8.944, P=0.029). However, the clinical survival rate was not significantly affected by any factors. Patients with low-grade ICRS lesion (ICRS grade 0, 1 or 2) showed a higher estimated 10-year anatomical survival rate compared with patients with high-grade ICRS lesions. (87.6% vs. 63.3%, P=0.022).
Conclusion
Low-grade ICRS lesion is associated with higher anatomical survival rate after medial MAT. In patients with high-grade ICRS lesions, the clinical outcome might be good; however, the status of an allograft might be poor. The surgeon should be aware of this and explain to the patient that close observation is necessary.