Clinical and radiologic outcomes after a modified bone plug technique with anatomical meniscal root reinsertion for meniscal allograft transplantation and a minimum 18-month follow-up

Abstract

Objective: To evaluate the clinical and radiologic outcomes of meniscal allograft transplantation (MAT) using a modified bone plug technique. Methods: We conducted a retrospective single-center study of 73 patients who underwent MAT between January 2007 and December 2013. The International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner score, visual analogue scale (VAS), and physical examinations were retrospectively reviewed to measure clinical outcomes after MAT, and questionnaires regarding activity and factors were analyzed. Magnetic resonance imaging (MRI) was used to assess the cartilage status and meniscal extrusion. Results: The mean follow-up was 37 months for 61 patients (65 knees), and 12 patients were lost to follow-up. The mean meniscal extrusion was 3.39±0.90 mm, the relative percentage of extrusion (RPE) was 34.82%±12.71%, and arthrosis progression was observed in 8 of 61 cases (13.1%). The mean results for VAS, IKDC, and Lysholm scores were significantly improved after MAT (P<0.05), but there were no significant differences in the range of motion or Tegner score (P>0.05). Thirty-eight (62.3%) patients were able to return to their previous level of activity, and 23 (37.7%) patients reached a mean 76.7% of the previous level of activity. Of the 23 patients reporting a decrease in activity, 10 reported a fear of reinjury as the primary factor limiting activity. The patient satisfaction rate in the study was 78.7%. Conclusion: Our modified bone plug method with anatomical meniscal root reinsertion was an effective surgical method, and the majority of active patients with meniscal disorders returned to preinjury levels of activity.