2025 ISAKOS Biennial Congress ePoster
The Static Allograft - Decreased Dynamic Meniscal Extrusion Alters Clinical Success 2 years after primary Medial or Lateral Meniscus Allograft Transplantation
Valentin Hingsamer, CM, Vienna AUSTRIA
Georg Brandl, MD, Vienna AUSTRIA
Edin Muji, MD, Vienna AUSTRIA
Thomas Hoffelner, MD, Prof, Vienna AUSTRIA
Sebastian Rilk, MD, NYC, New York UNITED STATES
Herz-Jesu Krankenhaus , Vienna, Vienna, AUSTRIA
FDA Status Not Applicable
Summary
Decreased dynamic meniscus movement leads to a significant reduction in patient outcomes two years after fully arthroscopic primary medial or lateral meniscus allograft transplantation, resulting in the implementation of the dead allograft sign
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Abstract
Introduction
To evaluate differences in patient-reported outcome measurements between patients
with normal (dME) and decreased sonographic dynamic meniscus extrusion (ndME) following primary
medial or lateral meniscus allograft transplantation (MAT).
Methods
Consecutive patients undergoing primary MAT by a single surgeon between July 2017 and
April 2021 were retrospectively evaluated. MAT was performed using fresh frozen suture-only fixated
allografts. Dynamic ultrasound imaging was performed by two examiners to assess meniscal extrusion
in both unloaded supine and weight-bearing standing positions. Decreased dME cut-off was defined
as <0.5 mm. All patients with a minimum of 2-year clinical follow-up were included in either the dME
(>0.5 mm) or ndME (<0.5 mm) group. Patients were excluded (n=8) based on the following exclusion
criteria: i) age: <18 or >60, ii) cartilage defects exceeding Kellgren-Lawrence grade 2, and iii) MAT
revision surgery. Subjective patient satisfaction after primary MAT was assessed using the IKDC score,
KOOS score, and Lysholm score at a minimum of 2-years follow-up. Clinical outcome scores were
compared using independent t-tests. Significance levels were defined as p < .05.
Results
A total of 26 patients (12 dME, 14 ndME group), with a mean age of 32.3 ±11.0 (dME) and 37
±11.2 (ndME) years, were evaluated at final follow-up of 3.3 ±1.1 (dME) and 3.5 ±1.3 (ndME) years.
Mean dynamic ME was significantly increased in the dME group as compared to the ndME group (1.0
±0.3 mm vs. 0.1 ±0.3 mm, p = <.01). At final 2-year follow-up, significant differences were observed
between the dME and ndME group comparing KOOS scores (89.0 ±8.7 (dME) vs. 71.4 ±24.2 (ndME), p
= .02) and Lysholm scores (93.1 ±9.5 (dME) vs. 76.2 ±24.6 (ndME), p = .03). However, there was no
significant difference for the IKDC score (89.9 ±8.7 (dME) vs. 78.3 ±18.4 (ndME), p = .05).
Conclusion
This study demonstrated that decreased dynamic meniscus extrusion negatively impacts
subjective functional outcomes in patients undergoing primary MAT at minimum 2-year follow-up.