Related Experiment Video
Updated: Dec 6, 2025
Destabilization of the Medial Meniscus and Cartilage Scratch Murine Model of Accelerated Osteoarthritis
Published on: July 6, 2022
Postoperative Subchondral Bone Marrow Lesion Is Associated With Graft Extrusion After Lateral Meniscal Allograft
Ju-Ho Song1, Seong-Il Bin1, Jong-Min Kim1
1University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Background:
Adverse effects of graft extrusion after meniscal allograft transplantation (MAT) are difficult to assess and can be determined only in the long term using a simple radiograph. Recently, subchondral bone marrow lesions (BMLs) detected on magnetic resonance imaging (MRI) scans have been used to evaluate the outcomes or prognoses of various knee surgeries. However, whether subchondral BMLs on MRI scans reflect the effects of allograft extrusion remains unclear.
Hypothesis:
Subchondral BML in the lateral compartment of the knee joint on postoperative MRI scans would be associated with graft extrusion after lateral MAT.
Study Design:
Case-control study; Level of evidence, 3.
Methods:
Overall, 170 patients with lateral MAT between 2008 and 2013 were classified into extrusion (≥3 mm) and nonextrusion (<3 mm) groups based on findings on MRI scans obtained 3 to 6 months postoperatively. Subchondral BMLs in the lateral compartment were evaluated on the latest MRI scans. To exclude any bone marrow signal changes other than those caused by allograft extrusion, the latest MRI scans were compared with those obtained 3 to 6 months postoperatively. Only subchondral BMLs that occurred after that time point were counted. The association between allograft extrusion and subchondral BML was assessed using chi-square analysis. Logistic regression analysis was performed to control other related factors, including age, sex, body mass index, time from previous meniscectomy, alignment, and cartilage status at the time of MAT. Clinical outcomes according to subchondral BML were evaluated using the Lysholm score.
Results:
Of the 170 patients, 20 (11.8%) had subchondral BML on the latest MRI scans at a mean 53.6 ± 31.2 months postoperatively, with 14 and 6 patients in the extrusion and nonextrusion groups, respectively. Chi-square analysis showed a significant association between allograft extrusion and subchondral BMLs (P = .025). Logistic regression analysis showed that extrusion and age were significant factors associated with subchondral BML (P = .011 and .004, respectively). However, no differences were observed in the Lysholm scores in accordance with the subchondral BML (P = .248).
Conclusion:
Subchondral BMLs on postoperative MRI scans were associated with graft extrusion after lateral MAT. However, there was no difference in clinical outcomes according to subchondral BML.
Insights
Subchondral bone marrow lesions (BMLs) on MRI scans after lateral meniscal allograft transplantation (MAT) are linked to graft extrusion. However, these lesions did not impact patient clinical outcomes.
Area of Science:
- Orthopedic Surgery
- Radiology
- Sports Medicine
Background:
- Graft extrusion after meniscal allograft transplantation (MAT) is challenging to assess long-term.
- Subchondral bone marrow lesions (BMLs) on MRI are increasingly used to evaluate knee surgery outcomes.
- The relationship between subchondral BMLs and allograft extrusion after MAT is not well understood.
Purpose of the Study:
- To investigate the association between subchondral BMLs on postoperative MRI and graft extrusion after lateral MAT.
- To determine if subchondral BMLs correlate with clinical outcomes following lateral MAT.
Main Methods:
- A case-control study included 170 patients who underwent lateral MAT.
- Patients were categorized into extrusion (≥3 mm) and nonextrusion (<3 mm) groups based on postoperative MRI.
- Subchondral BMLs were evaluated on later MRI scans, comparing them to early postoperative scans to identify new lesions. Association was analyzed using chi-square and logistic regression. Clinical outcomes were assessed using Lysholm scores.
Main Results:
- 11.8% of patients developed subchondral BMLs, with a significant association found between graft extrusion and BMLs (P = .025).
- Graft extrusion and patient age were significant predictors of subchondral BML development (P = .011 and P = .004, respectively).
- No significant difference in Lysholm scores was observed between patients with and without subchondral BMLs (P = .248).
Conclusions:
- Subchondral BMLs detected on postoperative MRI are associated with graft extrusion following lateral MAT.
- Despite the association with extrusion, subchondral BMLs did not correlate with improved or worsened clinical outcomes in this cohort.
More Related Videos
11:22Treatment of Osteochondral Defects in the Rabbit's Knee Joint by Implantation of Allogeneic Mesenchymal Stem Cells in Fibrin Clots
Published on: May 21, 2013
07:24Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018