Revision of meniscal transplants: long-term clinical follow-up

The primary aim is to document objective and subjective clinical outcome after knee arthroplasty for failed meniscal allograft transplantation; secondly, to investigate the influence of previous meniscal allograft surgery on the clinical outcome after a knee arthroplasty procedure; thirdly, to identify possible prognostic factors for the failure of meniscal allograft, such as potential number of concomitant procedures or pre-transplantation HSS-scores. The study population was compared to a control group of primary total knee arthroplasties.

The pre-operative phase, prior to meniscal allograft transplantation, was evaluated by the HSS questionnaire. At final follow-up, the clinical outcome was evaluated by the HSS, KOOS and SF-36 questionnaires. The mean follow-up was 16 years and 2 months. The control group, matched for age and sex, comprised patients with primary total knee arthroplasty.

Statistical analysis showed that for the HSS-scores, there was no significant difference between the study population and the control group. KOOS data showed that the control group scored better overall. There was no significant difference between the HSS-scores after the transplantation and after the knee prosthesis. However, both showed a significant improvement regarding the clinical condition before meniscal transplantation.

The clinical results after revised meniscal transplantation by means of knee prosthesis are highly variable with a tendency to have a lower score than patients with a primary knee prosthesis. Patients who underwent a revision of their meniscal allograft transplantation by means of a knee arthroplasty still had a significant better clinical outcome than prior to the meniscal allograft transplantation. There were no prognostic factors found by which one can determine whether a meniscal allograft will have a good survival or not.