Background: Few medium-term or long-term reports on meniscal
allograft transplantations are available. In this study, we present the
results of a survival analysis of the clinical outcomes of our first 100
procedures involving transplantation of viable medial and lateral meniscal
allografts performed in ninety-six patients.
Methods: Thirty-nine medial and sixty-one lateral meniscal
allografts were evaluated after a mean of 7.2 years. Survival analysis was
based on specific clinical end points, with failure of the allograft defined
as moderate occasional or persistent pain or as poor function. An additional
survival analysis was performed to assess the results of the sixty-nine
procedures that involved isolated use of a viable allograft (twenty of the
thirty-nine medial allograft procedures and forty-nine of the sixty-one
lateral allograft procedures) and of the thirteen viable medial meniscal
allografts that were implanted in combination with a high tibial osteotomy in
patients with initial varus malalignment of the lower limb.
Results: Overall, eleven (28%) of the thirty-nine medial allografts
and ten (16%) of the sixty-one lateral allografts failed. The mean cumulative
survival time (11.6 years) was identical for the medial and lateral
allografts. The cumulative survival rates for the medial and lateral
allografts at ten years were 74.2% and 69.8%, respectively. The mean
cumulative survival time and the cumulative survival rate for the medial
allografts used in combination with a high tibial osteotomy were 13.0 years
and 83.3% at ten years, respectively.
Conclusions: Transplantation of a viable meniscal allograft can
significantly relieve pain and improve function of the knee joint. Survival
analysis showed that this beneficial effect remained in approximately 70% of
the patients at ten years. This study identified the need for a prospective
study comparing patients with similar symptoms and clinical findings treated
with and without a meniscal allograft and followed for a longer period with
use of clinical evaluation as well as more objective documentation tools
regarding the actual fate of the allograft itself and the articular
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.