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Meniscal transplant

Michael A Zacchilli, Amos Z Dai, Eric J Strauss, Laith M Jazrawi, Robert J Meislin
The meniscus plays a vital role in knee biomechanics, and its physical absence or functional incompetence (e.g., irreparable root or radial tear) leads to unacceptably high rates of joint degeneration in affected populations. Meniscal allograft transplantation has been used successfully to treat patients with postmeniscectomy syndrome, and there is early laboratory and radiographic evidence hinting at a potential prophylactic role in preventing joint degeneration. We present a technique for lateral meniscal allograft transplantation using the CONMED Meniscal Allograft Transplantation system...
December 2017: Arthroscopy Techniques
Timothy B Pekari, Kevin C Wang, Eric J Cotter, Nicholas Kusnezov, Brian R Waterman
The purpose of this investigation is to report on trends over time in the treatment of meniscal pathology among military orthopaedic surgeons, as well as to evaluate the impact of patient demographics and concomitant procedure on the type of meniscal procedure performed. We performed a retrospective analysis of all active-duty United States military servicemembers who underwent a meniscal procedure from 2010 to 2015 within the Military Health System. Patient demographics and surgical variables were extracted from the electronic medical record...
March 7, 2018: Journal of Knee Surgery
Ahmed Mahmoud, James Young, Joanne Bullock-Saxton, Peter Myers
PURPOSE: To evaluate the survivorship of meniscal allograft transplantations (MATs), their clinical outcomes, and to compare the effect of perioperative cartilage status on survivorship. METHOD: A consecutive series of MATs with a minimum postsurgical time of 4 years were included from a prospectively collected database from 2001 to 2015. Mechanical failure was defined as transplant removal or knee arthroplasty. The effect of peri-operative cartilage status on survivorship was analyzed using a Kaplan-Meier analysis...
February 23, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ya-Dong Zhang, Shu-Xun Hou, Hong-Bin Zhong, Yi-Chao Zhang, Dian-Zhong Luo
The present study describes a novel all-arthroscopic technique for medial and lateral meniscal allograft transplantation (MAT). Surgical instruments were specifically designed to assist in the all-arthroscopic approach for MAT. The bone plug attachment technique, either the arthroscopic-assisted or all-arthroscopic approach, attaches bone plugs to the anterior and posterior horns. In the present study, two sets of surgical implements were designed: One to produce bone plugs of predefined sizes in the anterior and posterior horns of the allograft meniscus (bone plug implements) and a second to create bone tunnels in the receptor tibial plateau to hold the bone plugs (bone tunnel implements)...
March 2018: Experimental and Therapeutic Medicine
Dhong Won Lee, Jung Ho Park, Kyu Sung Chung, Jeong Ku Ha, Jin Goo Kim
The efficacy of meniscus allograft transplantation (MAT) for the meniscus-deficient knee has been widely recognized as being excellent in terms of pain relief and functional improvement. Lateral MAT is usually performed with the bone bridge technique that uses a bone bridge connecting the anterior and posterior horns of an allograft. The slot position for the meniscal graft insertion is of great importance with the bone bridge technique, especially in the key-hole method. The purpose of this Technical Note is to describe lateral MAT using the key-hole technique in which an allograft with a bone bridge carved to accommodate the key-hole-shaped slot is properly secured to the slot...
October 2017: Arthroscopy Techniques
Eric J Cotter, Rachel M Frank, Brian R Waterman, Kevin C Wang, Michael L Redondo, Brian J Cole
Surgical strategies for knee joint preservation are numerous, with the procedure(s) of choice for a given patient dependent on the status of the articular cartilage, meniscus, overall alignment, and ligamentous stability. For patients with large, isolated, osteochondral defects of the articular cartilage of the femoral condyle, osteochondral allograft transplantation (OCA) is often performed in an effort to reduce pain and improve function. Similarly, for appropriately indicated patients with symptomatic meniscus deficiency, meniscus allograft transplantation (MAT) is an excellent surgical solution...
October 2017: Arthroscopy Techniques
Dhong Won Lee, Jung Ho Park, Kyu Sung Chung, Jeong Ku Ha, Jin Goo Kim
The meniscal allograft transplantation (MAT) has been reported to be an effective treatment in terms of pain relief and functional improvement in symptomatic meniscus-deficient knee. The medial MAT is usually performed with the bone plug technique or soft tissue fixation for root fixation. We describe medial MAT with modified bone plug technique that permits easy passage of posterior bone plugs and facilitates bone-to-bone healing. With this method, an anterior bone plug with a long cylindrical shape is prepared, and the posterior bone plug is prepared with a flat bone shell containing a cancellous portion...
August 2017: Arthroscopy Techniques
Jarret M Woodmass, Nick R Johnson, Bruce A Levy, Michael J Stuart, Aaron J Krych
Lateral meniscus tears are commonly encountered by orthopaedic surgeons. Despite efforts to repair and preserve the meniscus, meniscectomy is occasionally required to treat irreparable tears. The resulting lateral meniscus deficiency leads to increased tibiofemoral contact pressures and ultimately early osteoarthritic changes in the knee. Lateral meniscal allograft transplant (LMAT) has been proposed as a way to restore the lateral meniscus-deficient knee to its native form. Although several techniques for LMAT have been proposed, osseous fixation has demonstrated increased stability, improved outcomes, and improved long-term survival...
August 2017: Arthroscopy Techniques
Daniel J Kaplan, Sergio A Glait, William E Ryan, Michael J Alaia, Kirk A Campbell, Eric J Strauss, Laith M Jazrawi
Over recent years, appreciation for the critical role of the meniscus in joint biomechanics has led to an emphasis on meniscal preservation. Meniscal allograft transplant (MAT) is a promising biological solution for the symptomatic young patient with a meniscus-deficient knee that has not developed advanced osteoarthritis. As surgical techniques are refined and outcomes continue to improve, it is vital to consider the utility of such procedures and offer a straightforward approach to MAT. This article and accompanying video provide a step-by-step tutorial on how to perform a MAT using the bridge and slot technique, its key pearls and pitfalls as well as the relevant advantages and disadvantages of MAT...
December 2017: Arthroscopy Techniques
N A Smith, N Parsons, D Wright, C Hutchinson, A Metcalfe, P Thompson, M L Costa, T Spalding
No abstract text is available yet for this article.
January 2018: Bone & Joint Journal
N A Smith, N Parsons, D Wright, C Hutchinson, A Metcalfe, P Thompson, M L Costa, T Spalding
AIMS: Meniscal allograft transplantation is undertaken to improve pain and function in patients with a symptomatic meniscal deficient knee compartment. While case series have shown improvements in patient reported outcome measures (PROMs), its efficacy has not been rigorously evaluated. This study aimed to compare PROMs in patients having meniscal transplantation with those having personalized physiotherapy at 12 months. PATIENTS AND METHODS: A single-centre assessor-blinded, comprehensive cohort study, incorporating a pilot randomized controlled trial (RCT) was performed on patients with a symptomatic compartment of the knee in which a (sub)total meniscectomy had previously been performed...
January 2018: Bone & Joint Journal
Zaira S Chaudhry, Brianna Fram, R Frank Henn, Seth L Sherman, Sommer Hammoud
Objective To identify the 50 most-cited articles in meniscal allograft transplantation (MAT) research and analyze their characteristics. Design In September 2017, the Scopus database was queried to identify the 50 most-cited articles in MAT research. Variables analyzed include number of citations, publication year, journal, institution, country of origin, article type, study design, and level of evidence. Citation density was calculated for each article. The correlation between citation density and publication year and the correlation between level of evidence and number of citations, citation density, and publication year were computed...
December 1, 2017: Cartilage
Justin J Mitchell, Mark E Cinque, Grant J Dornan, Lauren M Matheny, Chase S Dean, Brad Kruckeberg, Gilbert Moatshe, Jorge Chahla, Robert F LaPrade
PURPOSE: The purpose of this study was to evaluate the differences in intra-articular pathology, demographic characteristics, and radiographic characteristics of the knee associated with primary anterior cruciate ligament reconstruction (ACLR) versus revision ACLR at the time of initial presentation with either a native anterior cruciate ligament tear or an anterior cruciate ligament graft tear. Secondarily, we aimed to investigate risk factors for concomitant medial and lateral meniscal tears and cartilage injuries at the time of ACLR...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Dean Wang, Vivek Kalia, Claire D Eliasberg, Tim Wang, Francesca R Coxe, Mollyann D Pais, Scott A Rodeo, Riley J Williams
BACKGROUND: Treatment of large chondral defects of the knee among patients aged ≥40 years remains a difficult clinical challenge owing to preexisting joint degeneration and the lack of treatment options short of arthroplasty. PURPOSE: To characterize the survivorship, predictors of failure, and clinical outcomes of osteochondral allograft transplantation (OCA) of the knee among patients aged ≥40 years. STUDY DESIGN: Case series; Level of evidence, 4...
March 2018: American Journal of Sports Medicine
Susanne M Eijgenraam, Max Reijman, Sita M A Bierma-Zeinstra, Daan T van Yperen, Duncan E Meuffels
NHS-PROSPERO REGISTRATION NUMBER: 42016048592 OBJECTIVE: In order to make a more evidence-based selection of patients who would benefit the most from arthroscopic partial meniscectomy (APM), knowledge of prognostic factors is essential. We conducted a systematic review of predictors for the clinical outcome following APM. DESIGN: Systematic review DATA SOURCES: Medline, Embase, Cochrane Central Register, Web of Science, SPORTDiscus, PubMed Publisher, Google Scholar INCLUSION CRITERIA: Report an association between factor(s) and clinical outcome; validated questionnaire; follow-up >1 year...
November 28, 2017: British Journal of Sports Medicine
Brian H Park, Scott A Banks, Antonio Pozzi
The dog has been used extensively as an experimental model to study meniscal treatments such as meniscectomy, meniscal repair, transplantation and regeneration. However, there is very little information on meniscal kinematics in the dog. This study used MR imaging to quantify in vitro meniscal kinematics in loaded dog knees in four distinct poses: extension, flexion, internal and external rotation. A new method was used to track the meniscal poses along the convex and posteriorly tilted tibial plateau. Meniscal displacements were large, displacing 13...
November 6, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Bryan M Saltzman, Maximilian A Meyer, Timothy S Leroux, Matthew E Gilelis, Margot Debot, Adam B Yanke, Brian J Cole
PURPOSE: To compare a series of patients who underwent meniscus allograft transplantation (MAT) with full-thickness chondral defects (FTD) with those with no chondral defect (ND) with regard to the following: change in patient-reported outcomes (PROs) from baseline to 2-year follow-up and baseline to the final follow-up (including comparisons to minimal clinically important differences), complications and complication rates, reoperations and reoperation rates/timing, and failures and time to failure (revision MAT or conversion to total knee arthroplasty)...
November 2, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Mark E Cinque, Jorge Chahla, Gilbert Moatshe, Nicholas N DePhillipo, Nicholas I Kennedy, Jonathan A Godin, Robert F LaPrade
BACKGROUND: Until recently, anterior cruciate ligament (ACL) tears in older patients were treated conservatively; however, these patients often experienced significant pain and instability. PURPOSE/HYPOTHESIS: The purpose of this study was to compare the patient-reported outcomes, patient satisfaction, and failure rates of primary ACL reconstruction between a younger (age 20-30 years) and older (age 50-75 years) patient cohort. It was hypothesized that patients in the older cohort could achieve comparable clinical outcomes and retear rates following ACL reconstruction with a bone-tendon-bone autograft or allograft compared with the younger patients...
October 2017: Orthopaedic Journal of Sports Medicine
Yong Seuk Lee, O-Sung Lee, Seung Hoon Lee
OBJECTIVE: The aim of this systematic review was to determine the time to and rate of the return to sports (RTS) after meniscal surgery and to compare these values among the different types of meniscal surgeries. STUDY DESIGN: Systematic review. METHODS: The MEDLINE, EMBASE, and Cochrane databases were searched. Studies that met the following criteria were included: (1) English article, (2) full-text available, (3) study on athletes, and (4) primary outcome is RTS after meniscal surgery, such as meniscectomy, meniscal repair, and meniscal allograft transplantation (MAT)...
October 5, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Bum-Sik Lee, Hyun-Jung Kim, Chang-Rack Lee, Seong-Il Bin, Dae-Hee Lee, Na-Jin Kim, Chang-Wan Kim
BACKGROUND: While additional procedures correcting accompanying pathological conditions can improve the clinical outcomes of meniscal allograft transplantation (MAT), whether those outcomes are comparable or poorer than those of isolated MAT has yet to be clarified. PURPOSE:  To evaluate whether there is a difference in clinical outcomes between isolated MAT and MAT combined with other procedures (combined MAT). STUDY DESIGN: Meta-analysis and systematic review...
September 1, 2017: American Journal of Sports Medicine
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