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- Title
Clinical and Radiological Outcomes of Medial Meniscal Allograft Transplantation Combined With Realignment Surgery.
- Authors
Lee, Dhong Won; Kang, Sung Jin; Kim, Rak Jun; Cho, Seung Ik; Moon, Sung Gyu; Yang, Sang Jin; Kim, Jin Goo
- Abstract
Background: The outcomes of medial meniscal allograft transplantation (MMAT) combined with high tibial osteotomy (HTO) compared with isolated MMAT remain unclear. Purpose: To compare the clinical and radiological results of MMAT combined with HTO and isolated MMAT. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included 42 consecutive patients, who were divided into group M (isolated MMAT; n = 22) and group H (MMAT combined with HTO with a varus angle >3°; n = 20). Group differences in subjective knee scores, isokinetic muscle strength test, and radiological outcomes (Kellgren-Lawrence grade, mechanical axis, graft extrusion, graft status, and articular cartilage loss) were compared. Results: The mean follow-up period was 29.2 ± 4.9 months and 27.4 ± 5.3 months for groups M and H, respectively. The Lysholm score improved from 55.4 ± 9.5 to 81.3 ± 9.7 and from 52.6 ± 8.9 to 84.2 ± 10.2 in groups M and H, respectively (both P <.001). The International Knee Documentation Committee subjective score improved from 51.4 ± 10.3 to 79.6 ± 9.4 and from 49.3 ± 11.4 to 81.4 ± 8.3 in groups M and H, respectively (both P <.001). Both groups showed no significant differences in subjective knee scores and isokinetic extensor strength at the final follow-up. The rate of preoperative and postoperative high International Cartilage Regeneration & Joint Preservation Society grade (≥3) did not differ between the 2 groups. Group M showed greater coronal graft extrusion than did group H (3.3 ± 0.7 mm vs 2.7 ± 0.8 mm; P =.014); the rate of pathologic graft extrusion (≥3 mm) was not higher in group M (40.9%) than in group H (20%) with the number of patients available (P =.143). Both groups showed no significant difference in the graft status. Graft tears were observed in 2 patients (9%) in group M and 1 patient (5%) in group H (P =.607). Conclusion: Clinical scores significantly improved after isolated MMAT and MMAT combined with HTO compared with preoperative values, and their short-term outcomes were similar. Postoperative graft extrusion was greater in patients who underwent isolated MMAT, implying that active correction of varus alignment during MMAT may help in intra-articular biomechanics.
- Subjects
MENISCUS surgery; KNEE physiology; POSTOPERATIVE care; MENISCUS (Anatomy); T-test (Statistics); DATA analysis; BODY mass index; BONE diseases; SCIENTIFIC observation; QUESTIONNAIRES; HOMOGRAFTS; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics; MAGNETIC resonance imaging; MANN Whitney U Test; KNEE joint; OSTEOTOMY; LONGITUDINAL method; MUSCLE strength; MEDICAL records; ACQUISITION of data; STATISTICS; INTRACLASS correlation; KNEE; COMPARATIVE studies; HEALTH outcome assessment; EXERCISE tests; DATA analysis software; MUSCLE contraction
- Publication
American Journal of Sports Medicine, 2024, Vol 52, Issue 9, p2260
- ISSN
0363-5465
- Publication type
Article
- DOI
10.1177/03635465241255346