Summary: The objective and subjective results of the present study indicate that combined all-arthroscopic meniscal allograft transplantation with bone-bridge and autologous chondrocyte implantation using chondrospheres is a safe and valid option for the treatment of patients with combined meniscal insufficiency and chondral lesions.

Purpose

Meniscectomy has detrimental effects on the knee joint. Meniscal allograft transplantation (MAT) is a salvage procedure to improve function, as well as counteract accelerated articular degeneration. However, it is still unclear whether MAT should be performed in patients with concomitant chondral damage. The purpose of this study was to evaluate clinical outcomes, patient satisfaction, and magnetic resonance imaging after combined MAT and ipsicompartmental autologous chondrocyte implantation (ACI) using chondrospheres in patients with severe meniscal insufficiency and high-grade chondral defects to assess its viability as a biological alternative to arthroplasty. Our hypotheses were that this combined approach would be able to significantly improve outcome measures at a low failure rate even with coexisting chondral damage, and that cartilage lesions should therefore not be a contraindication for MAT.

Methods

This study constitutes a retrospective single-surgeon clinical follow-up study (level of evidence IV). We identified 23 consecutive patients who underwent combined arthroscopic MAT with bone bridge and arthroscopic ACI between 2010 and 2018 and matched the eligibility criteria. The following outcome measures were prospectively obtained both pre- and postoperatively: International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner activity scale, MOCART score, and visual analog scale for patient satisfaction. The IKDC subjective score was the primary outcome measure and a p value < 0.05 was considered significant. Arithmetic mean and standard deviation were calculated for complete datasets. Pre- and postoperative values were compared with paired t tests.

Results

Twenty-one patients (91.3%) were available for follow-up (13 male, 8 female), including 16 lateral and 5 medial MATs. The mean age was 30.8 ± 9.8 years. The mean chondral defect size was 4.5 ± 2.7 cm2. A kissing lesion was present in 33% of patients. The mean follow-up was 58.2 ± 27.4 months. All clinical outcome measures showed statistically significant improvements. IKDC subjective scores improved from 51.3 ± 16.8 to 73.2 ± 14.1 (p < 0.001). Lysholm scores improved from 61.4 ± 22.1 to 82.3 ± 10.5 (p < 0.001). Visual analog scale for patient satisfaction improved from 2.8 ± 2.3 to 7.5 ± 2.2 (p < 0.001). All KOOS subcategories, KOOS total, and Tegner activity scale also showed statistically significant improvements (p = 0.011). The overall transplant survival rate was 90.5% at final follow-up, with MAT accounting for 100% of failure events. No failures of ACI were observed in our cohort. The most common cause for reoperation was re-suturing of the meniscal allograft, with an overall reoperation rate of 38.1%. The mean MOCART score was 67.5 ± 15.2 and presence of a kissing lesion was indicative of worse postoperative outcomes in our cohort.

Conclusions

These results support the emerging hypothesis that combined MAT and ACI using chondrospheres is a viable and safe option for the treatment of patients with meniscal insufficiency and concomitant chondral damage capable of improving function, reducing symptoms, and increasing patient satisfaction, at acceptable failure and reoperation rates. This indicated that chondral damage should not be a contraindication for MAT.

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Less Than 10% Failure Rate in Patients with Bucket-Handle Meniscal Tear Repair After 4 Years Follow-Up ePoster Presentation Tomas Alfredo Esteves, MD, ARGENTINA Ignacio Astore, MD, ARGENTINA Carlos H. Yacuzzi, MD, ARGENTINA Matias Costa-Paz, MD, PhD, ARGENTINA Juan Pablo Zicaro, MD, ARGENTINA
Medial Meniscus Repair only Partially Restores In-Vivo Knee Kinematics after ACL Reconstruction ePoster Presentation Alberto Grassi, PhD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Gian Andrea Lucidi, MD, ITALY Erika Pinelli, MsC, ITALY Gregorio Marchiori, MD, ITALY Marco Bontempi, PhD, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
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Predictors of Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction With Concurrent Treatment of Bucket-Handle Meniscus Tears ePoster Presentation Gregory Perraut, MD, UNITED STATES Rachel E Cherelstein, BS, UNITED STATES Alexandra Galel, MD, UNITED STATES Laura Keeling, MD, UNITED STATES Christopher M Kuenze, PhD, UNITED STATES Andrew Curley, MD, UNITED STATES David X. Wang, MD, UNITED STATES Kaitlin A Malekzadeh, , UNITED STATES Edward S. Chang, MD, UNITED STATES
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Morphological Analysis of Discoid Lateral Meniscus on Magnetic Resonance Imaging Comparing Pre- and Postoperative Images ePoster Presentation Shunya Tsuji, MD, JAPAN Masakazu Ishikawa, MD, PhD, JAPAN Naofumi Hashiguchi, MD,MPH, JAPAN Goki Kamei, MD, PhD, JAPAN Atsuo Nakamae, MD, PhD, JAPAN Nobuo Adachi, MD, PhD, JAPAN
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Lateral Meniscus Root Tear in ACL-Injured Patients Results In High-Grade Rotatory Knee Laxity: A Quantitative Pivot Shift Analysis ePoster Presentation Bálint Zsidai, MD, SWEDEN Gian Andrea Lucidi, MD, ITALY Ryosuke Kuroda, MD, PhD, JAPAN James J. Irrgang, PT, PhD, FAPTA, UNITED STATES Kristian Samuelsson, Prof, MD, PhD, MSc, SWEDEN Stefano Zaffagnini, MD, Prof., ITALY Volker Musahl, MD, Prof., UNITED STATES
Clinical Outcomes After the Repair of Isolated Full Radial Tear at Midbody of Lateral Meniscus - All-Inside Suture Repair vs Trans-Capsular Suture Repair - ePoster Presentation Ryohei Uchida, MD, PhD, JAPAN Shuji Horibe, MD, PhD, JAPAN Yoshinari Tanaka, MD, PhD, JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Yuta Tachibana, M.D., Ph.D., JAPAN Akira Tsujii, MD, PhD, JAPAN Konsei Shino, MD, PhD, JAPAN
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The Fate of Discoid Lateral Meniscus With and Without Osteochondritis Dissecans of the Lateral Femoral Condyle After Surgery ePoster Presentation Ken Iida, MD, JAPAN Yusuke Hashimoto, MD, PhD, JAPAN Yohei Nishida, MD, JAPAN Junsei Takigami, MD, PhD, JAPAN Tomohiro Tomihara, MD, JAPAN Hiroaki Nakamura, MD, PhD, JAPAN
Etiology of Posterior Meniscus Root Tears: Medial vs. Lateral ePoster Presentation Katrin Karpinski, MD, GERMANY Philipp Forkel, MD, GERMANY Martin Häner, MD, GERMANY Wolf Petersen, MD, Prof, GERMANY
Outcomes of Arthroscopic All-Inside Repair are Improved Compared to Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tears ePoster Presentation Kyoung Ho Yoon, MD, PhD, Prof., KOREA, REPUBLIC OF Jae-Young Park, MD, KOREA, REPUBLIC OF Cheol Hee Park, MD, PhD, KOREA, REPUBLIC OF Sang-Gyun Kim, MD, PhD, KOREA, REPUBLIC OF Yoon-Seok Kim, MD, KOREA, REPUBLIC OF Hee Sung Lee, MD, KOREA, REPUBLIC OF Sung Hyun Hwang, MD, KOREA, REPUBLIC OF Dae Keun Suh, MD, PhD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF
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Popliteomeniscal Fascicles Tears with Lateral Meniscus Instability: Outcomes of Arthroscopic Surgical Technique at Mid-Term Follow-Up ePoster Presentation Simone Cerciello , DR, ITALY Gianluca Ciolli, MD, ITALY Fabrizio Mocini, MD, ITALY Dario Candura, ITALY Lorenzo Proietti, MD, ITALY Roberto Simonetta, ITALY Katia Corona, MD, ITALY Gianni Di Vico, MD, ITALY
Good Clinical Results And Patient Satisfaction After Arthroscopic Repair of Large Meniscus Bucket Handle Tears of the Knee ePoster Presentation Johannes Pawelczyk, cand. med., GERMANY Rainer Siebold, Prof. Dr. med., GERMANY
Biomechanics Comparison Between Transtibial Pullout, Suture Anchor And All-Suture Anchor Technique For Posterior Medial Meniscal Repair ePoster Presentation Nadhaporn Saengpetch, MD, THAILAND Napat Prasitmeeboon, MD, THAILAND Tanapol Janyawongchot, MD, THAILAND Sorawut Thamyongkit , MD, THAILAND
Meniscal Repair Is A Solution In “Older” Patients: A Systematic Literature Review with Meta-Analysis ePoster Presentation Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR Chris Saunders, PhD MBChB BMedSci (Hons), UNITED KINGDOM Matthew Sedgwick, Ph.D., UNITED KINGDOM
Bone Bridge Technique For Lateral Meniscal Allograft Transplantation – No Difference In Clinical Outcome Compared To The Soft Tissue Technique ePoster Presentation Rahul Bhattacharyya, MBCHB (Hons), MD (Res), FRCS (Orth), MSc, MRCS, UNITED KINGDOM Harry Krishnan, FRCS(Tr&Orth),MEd(ULT), MBBS, BSc (Hons), UNITED KINGDOM Nicole Bausch, MSc physiotherapy and education, UNITED KINGDOM Adam Richard Pilarski, MBBS, MRCS, MBA, BA (hons), UNITED KINGDOM Niall McGoldrick, MB MCh FRCS (Tr & Orth), IRELAND Peter Thompson, MBChB, UNITED KINGDOM Andrew Metcalfe, PhD, UNITED KINGDOM Tim Spalding, FRCS(Orth), UNITED KINGDOM
Evolution in the Indication of Surgical Treatment on Degenerative Meniscal Tears In the Last 20 Years ePoster Presentation Alejandro Espejo-Reina, MD, MSc, SPAIN Enrique Sevillano-Perez, MD, SPAIN María Josea Espejo-Reina, MD, SPAIN Maximiano Lombardo-Torre, SPAIN Miguel Verdejo-Parrilla, MD, MSc, SPAIN Alejandro Espejo-Baena, MD, SPAIN
Non-Extruded Grafts Result in Better Cartilage Quality after Lateral Meniscal Allograft Transplantation: Quantitative 3-T MRI T2 Mapping ePoster Presentation Seong-Il Bin, MD, PhD, KOREA, REPUBLIC OF Jong-Min Kim, MD, PhD, KOREA, REPUBLIC OF Bum-Sik Lee, MD, KOREA, REPUBLIC OF Hyo Yeol Lee, MD, PhD, KOREA, REPUBLIC OF Ju-Ho Song, MD, KOREA, REPUBLIC OF Ho Yeon Kim, MD, KOREA, REPUBLIC OF Jaejung Ryu, MD, KOREA, REPUBLIC OF
Mid-Term Clinical And Radiological Outcomes of Lateral Meniscal Allograft Transplantation With Suture-Only Fixation Plus Capsulodesis ePoster Presentation Àngel Masferrer-Pino, MD PhD, SPAIN Rodolfo Morales-Avalos, MD, PhD., MEXICO Maximiliano Ibañez, MD, SPAIN Simone Perelli, MD,PhD, SPAIN Pablo E. Gelber, MD, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Increased Mechanical Axis Malalignment Does Not Lead to Worse Outcomes Following Transtibial Meniscus Root Repair ePoster Presentation Logan M. Good, BS, UNITED STATES Reid Palumbo, BS, UNITED STATES Parker Cavendish, BS, UNITED STATES Eric Milliron, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES James C. Kirven, BS, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES
Evolution in the Indication of Surgical Treatment on Repairable Meniscal Tears and Their Treatment in the Last 20 Years ePoster Presentation Alejandro Espejo-Reina, MD, MSc, SPAIN Enrique Sevillano-Perez, MD, SPAIN María Josea Espejo-Reina, MD, SPAIN Maximiano Lombardo-Torre, SPAIN Miguel Verdejo-Parrilla, MD, MSc, SPAIN Alejandro Espejo-Baena, MD, SPAIN
Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies ePoster Presentation Enzo Salviato Mameri, MD, MSc, BRAZIL Garrett Jackson, MD, UNITED STATES Harkirat Jawanda, BS, UNITED STATES Jonathan A Gustafson, PhD, UNITED STATES Leonardo Metsavaht, MD PhD, BRAZIL Jorge Chahla, MD, PhD, UNITED STATES
Concomitant Medial Meniscal Ramp Lesions and Lateral Meniscal Tears with Anterior Cruciate Ligament Injuries are Associated with Anterior Tibial Subluxation in Knee Extension ePoster Presentation Hibiki Kakiage, MD, JAPAN Kazuhisa Hatayama, MD, PhD, JAPAN Satoshi Nonaka, MD, JAPAN Masanori Terauchi, MD, JAPAN Atsufumi Oshima, MD, JAPAN HIrotaka Chikuda, MD, PhD, JAPAN
Strength-Based Rehabilitation On Clinical Outcomes In Patients Post-Meniscectomy: A Systematic Review and Meta-Analysis ePoster Presentation Prushoth Vivekanantha, MD, CANADA Yi (David) Diao, BMSc, CANADA Dan Cohen, MD, CANADA Ben Murphy, DPT, CANADA Darren L. de SA, MD MBA FRCSC, CANADA
Clinical Characteristics Of Isolated Meniscal Tears During Sports Activities Among Young Athletes ePoster Presentation Yuta Tachibana, M.D., Ph.D., JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Hiroshi Amano, MD, PhD, JAPAN Keisuke Kita, MD, PhD, JAPAN Yasukazu Yonetani, MD, PhD, JAPAN Shuji Horibe, MD, PhD, JAPAN Yoshinari Tanaka, MD, PhD, JAPAN
Lateral Meniscal Posterior Root Repair with Concurrent ACL Reconstruction: Patient-Report Outcomes and Risk Factors for Failure ePoster Presentation Evan W. James, MD, UNITED STATES Per-Henrik Randsborg, MD, PhD, NORWAY Joseph T. Nguyen, MPH, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Answorth A. Allen, MD, UNITED STATES Scott A. Rodeo, MD, UNITED STATES Robert G. Marx, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
A New Arthroscopic Pull-In All-Suture Anchor Meniscus Root Tear Repair Shows Comparable Biomechanical Properties as Conventional Trans-Osseous Pull-Out and Anchor Repair ePoster Presentation Thorben Briese, MD, GERMANY Amaris Kieninger, MD, GERMANY Elmar Herbst, MD, PhD, GERMANY Johannes Glasbrenner, MD, GERMANY Christian Peez, MD, GERMANY Adrian Deichsel, MD, GERMANY Maurice Balke, MD, GERMANY Jens Wermers, MD, GERMANY Matthias Klimek, M. Sc., GERMANY Michael J. Raschke, MD, Prof., GERMANY Christoph Kittl, MD, MD(res), GERMANY
Risk Factors Affecting the Survival Rate of Collagen Meniscus Implant (CMI) For Partial Meniscus Deficiency. An Analysis Of 156 Consecutive Cases at A Mean 10 Years of Follow-Up ePoster Presentation Gian Andrea Lucidi, MD, ITALY Alberto Grassi, PhD, ITALY Piero Agostinone, MD, QATAR Stefano Di Paolo, Eng, PhD, ITALY Giacomo Dal Fabbro, MD, AUSTRALIA Nicola Pizza, MD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
Clinical Outcomes Of Lateral Meniscus Posterior Root Repair In The Acl-Reconstructed Knees ePoster Presentation Lika Dzidzishvili, MD, PhD, SPAIN Irene Isabel López-Torres, MD, PhD, SPAIN David Sáez, MD, SPAIN Antonio Hernández Diez, MD, SPAIN Emilio Calvo, MD, PhD, MBA, SPAIN

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Good Clinical Results After Combined Arthroscopic Meniscal Allograft Transplantation and Autologous Chondrocyte Implantation Using Chondrospheres

Good Clinical Results After Combined Arthroscopic Meniscal Allograft Transplantation and Autologous Chondrocyte Implantation Using Chondrospheres

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Good Clinical Results After Combined Arthroscopic Meniscal Allograft Transplantation and Autologous Chondrocyte Implantation Using Chondrospheres

Good Clinical Results After Combined Arthroscopic Meniscal Allograft Transplantation and Autologous Chondrocyte Implantation Using Chondrospheres

Purpose

Methods

Results

Conclusions

More 2023 ISAKOS Congress Content