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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Polyurethane Meniscal Scaffold In Postmeniscectomy Syndrome Presented Good Clinical Results At Minimum 10-Years Of Follow-Up ePoster Presentation Maximiliano Ibañez, MD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Pablo E. Gelber, MD, PhD, SPAIN Simone Perelli, MD,PhD, SPAIN Daniel Pérez-Prieto, MD, SPAIN Àngel Masferrer-Pino, MD PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
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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
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Continuous Vertical Inside-Out Versus Traditional Vertical Inside-Out Meniscal Repair: A Biomechanical Comparison ePoster Presentation José Leonardo Rocha De Faria , MD, MSc, BRAZIL Arthur Paiva Grimaldi Santos, M.Sc., BRAZIL Douglas Mello Pavão, MD, MSc, PhD, BRAZIL Mariana Radulski, Medical Student, BRAZIL Ana Carolina Leal, PhD, BRAZIL Ari Digiácomo Ocampo Moré, PhD, BRAZIL Alan de Paula Mozella, PhD, Prof., BRAZIL Joao ANTONIO MATHEUS GUIMARAES, BRAZIL Robert F. LaPrade, MD, PhD, UNITED STATES Carlos Rodrigo De Mello Roesler, PhD, BRAZIL Rodrigo Salim, MD,PhD, BRAZIL
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Biomechanical Comparison Of Novel Meniscus Cap Repair Technique With Simple Meniscus Suture And Collagen Matrix Meniscus Suture Techniques For Complex Tears Of The Medial Meniscus ePoster Presentation Kinga Ciemniewska-Gorzela, PhD, POLAND
Biomechanics Of Different Surgical Techniques For Posterior Medial Meniscal Root Repair: A Porcine Model ePoster Presentation Nadhaporn Saengpetch, MD, THAILAND Sutip Noowan, Md, THAILAND Chaiyanun Vijittrakarnrung, MD, THAILAND
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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
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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
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
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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
Accuracy of Magnetic Resonance Imaging for Detecting Meniscal Tears in Anterior Cruciate Ligament injuries. ePoster Presentation Artit Boonrod, MD, THAILAND Watcharapong Wongsawiang , MD, THAILAND Punthip Thammaroj , MD, THAILAND Sermsak Sumanont, THAILAND Punyawat Apiwatanakul, MD, THAILAND Arunnit Boonrod, MD, THAILAND
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
No Dynamic Extrusion of the Medial Meniscus in Ultrasound Examination in Patients with Confirmed Root Tear Lesion ePoster Presentation Katrin Karpinski, MD, GERMANY Theresa Diermeier, MD, GERMANY Lukas Willinger, MD, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Andrea E. Achtnich, Assoc. Prof., GERMANY Wolf Petersen, MD, Prof, GERMANY
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The High Prevalence of Spin Reporting Bias in Meniscal Allograft Transplant Abstracts: A Qualitative Assessment Of Systematic Reviews and Meta-Analyses ePoster Presentation Matthew T Gulbrandsen, MD, UNITED STATES Mustafa Hashimi, BS, UNITED STATES Taha Taka, BS, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Anthony Essilfie, MD, UNITED STATES Anikar Chhabra, MD, MS, UNITED STATES Seth L. Sherman, MD, UNITED STATES
Anatomical Survival of the Graft After Medial Meniscal Allograft Transplantation is Better in Patients with Lower-Grade ICRS Lesions: MRI-Based Objective Evaluation 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 seonjong Lee, MD, KOREA, REPUBLIC OF Ju-Ho Song, MD, KOREA, REPUBLIC OF Ho Yeon Kim, MD, KOREA, REPUBLIC OF Jaejung Ryu, MD, KOREA, REPUBLIC OF
Knee Cartilage and Meniscus in Recreational marathon runners: a MRI T2 * mapping investigation ePoster Presentation Siyu Dai, PhD, CHINA Feng Chen, PhD, CHINA Dingbo Shu, MD, CHINA Fanjing Meng, MD, CHINA Le Wang, MD, CHINA Yanjing Zhang, MD, CHINA Jianping Ding, MD, CHINA
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
The Hidden Lesion of the Knee: Risk Factors Study ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Anis Tebourbi, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Rami Triki, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
Determinants of Radiologic and Functional Outcomes after Meniscal Repair of Longitudinal Vertical Tears. A Prospective Cohort Study of 78 patients. ePoster Presentation Benjamin Tschopp, MD, SWITZERLAND Robin Martin, MD, SWITZERLAND
Biomechanical Effect of Unstable Meniscal Injury on Gait in ACL-Deficient and -Reconstructed Knees ePoster Presentation Kengo Harato, MD, PhD, JAPAN Kohei Nishizawa, PhD, JAPAN Shu Kobayashi, MD, PhD, JAPAN Yasuo Niki, MD, PhD, JAPAN Takeo Nagura, MD, JAPAN
Delaying ACL Reconstruction Increases the Risk of Medial Meniscal Tear ePoster Presentation Julien Erard, MD, FRANCE Nicolas Cance, MD, FRANCE Jobe Shatrov, MD, AUSTRALIA Gaspard Fournier, MD, FRANCE Stanislas Gunst, MD, FRANCE Gianluca Ciolli, MD, ITALY Pasquale Porcelli, MD, ITALY Sebastien Lustig, MD, PhD, Prof., FRANCE Elvire Servien, MD, PhD, Prof., FRANCE
Can Local Anesthesia be Considered as Gold Standard in Knee Arthroscopy? ePoster Presentation Tilemachos Papageorgiou, MD, GREECE Stefanos Christos Papageorgiou, MD, GREECE ILIAS SOTIRIADIS, MD, GREECE Tsoumanis Dimitrios, MD, GREECE Christos D. Papageorgiou, MD, PhD, GREECE
"Repair Or Resect? That Is The Question!" Inside-Out Repair Of Long Meniscus Tears Is Used to Identify Prognostic Factors and Improve Decision-Making ePoster Presentation Iftach Hetsroni, MD, Associate Prof., ISRAEL Yakir Carmeli, B.Ed., ISRAEL Shiri Bretter, M.ed, ISRAEL Gabriel Marino, MD, ISRAEL Ayelet Gonen-Vonkler, BA, ISRAEL Altaieb Agbaria, MD, ISRAEL Gideon Mann, MD, Prof., ISRAEL Nissim Ohana, MD, ISRAEL Moshe Ayalon, PhD, ISRAEL
Posterior Cruciate Buckling Angle Variations are Associated With Different Patterns of Medial Meniscus Tears in Anterior Cruciate Deficient Knees: Results of a Prospective Comparative Magnetic Imaging Resonance Study ePoster Presentation Simone Cerciello , DR, ITALY Gianluca Ciolli, MD, ITALY Dario Candura, ITALY Michele Mercurio, Prof., MD, ITALY Fabrizio Mocini, MD, ITALY Lorenzo Proietti, MD, ITALY

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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