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Meniscal Allograft Transplants in Skeletally Immature Patients: A Systematic Review of Indications and Outcomes
Marco Turati1,2,3,4, Linda Boerci1, Massimiliano Piatti3,5
1School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy.
Insights
Meniscal allograft transplant (MAT) surgery shows promise for improving knee stability and function in pediatric patients. However, it presents a high complication rate, necessitating careful patient selection and further long-term research.
Area of Science:
- Orthopedic Surgery
- Pediatric Sports Medicine
- Regenerative Medicine
Background:
- Meniscal lesions in young patients can cause knee instability and joint damage.
- Meniscal allograft transplant (MAT) is a surgical option to restore knee stability.
- Evidence on MAT outcomes in pediatric populations is limited.
Purpose of the Study:
- To systematically review the outcomes of meniscal allograft transplant (MAT) surgery in skeletally immature patients.
- To evaluate the safety and efficacy of MAT in pediatric knee conditions.
- To identify indications and complication rates associated with pediatric MAT.
Main Methods:
- A systematic review adhering to PRISMA guidelines was performed.
- Searches were conducted in PubMed, Scopus, and EMBASE databases (1965-June 2022).
- Studies were assessed using the Newcastle-Ottawa Scale (NOS), including 58 patients across 3 studies.
Main Results:
- The lateral meniscus was the most frequently transplanted allograft (82.8%).
- Indications included post-meniscectomy syndrome and discoid meniscus.
- Improved subjective scores and sports participation were reported, with a 27.5% complication rate.
Conclusions:
- MAT surgery can enhance clinical outcomes in carefully selected pediatric patients.
- The procedure is safe in the absence of limb malalignment but carries a significant complication risk.
- Long-term follow-up is crucial for definitive conclusions on MAT in skeletally immature individuals.
Abstract:
Meniscal lesions in skeletally immature patients can lead to joint degradation and knee instability. Meniscal allograft transplant (MAT) surgery is a solution to maintain knee stability. There is a lack of consensus on MAT surgery outcomes in pediatric patients. A systematic review was conducted according to the PRISMA guidelines. PubMed, Scopus and EMBASE databases were searched from 1965 to June 2022. Studies were evaluated using the Newcastle-Ottawa Scale (NOS). Three studies were selected, and 58 patients were included (mean age 15.9 years) in total. The lateral meniscus was involved in 82.8% of all MAT surgeries. Post-meniscectomy syndrome and discoid meniscus were the main indications for MAT surgery. All studies reported improved subjective clinical scores and levels of sport after the surgery. The complication rate was 27.5%. Partial meniscectomy, meniscus knot removal, chondral defect treatment and lysis of adhesions were the most frequent procedures performed during reoperation. MAT surgery can improve clinical outcomes in pediatric patients with strictly selected indications. MAT surgery is safe when there are no limb asymmetries or malalignments, but it remains a challenging procedure with a high complication rate. Long-term follow-up is needed for definitive statements on the use of MAT in skeletally immature patients.
