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Risk Factors for Graft Failure After Meniscal Allograft Transplantation: A Systematic Review and Meta-analysis.

Kyle N Kunze1, Ryann A Davie1, Prem Narayan Ramkumar2,3

  • 1Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.

Orthopaedic Journal of Sports Medicine
|July 12, 2023
PubMed
Summary

Graft failure after knee meniscal allograft transplantation (MAT) is linked to cartilage damage severity. Patient sex and transplant side did not significantly impact failure risk in this review.

Keywords:
failuregraftkneemeniscal allograft transplantationmeta-analysis

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Regenerative Medicine

Background:

  • Meniscal allograft transplantation (MAT) failure can lead to revision surgery or knee replacement.
  • Understanding MAT failure risk factors is crucial for patient counseling and surgical decision-making.
  • Identifying predictors of MAT failure can optimize patient selection and outcomes.

Purpose of the Study:

  • To systematically review and meta-analyze risk factors associated with graft failure following knee meniscal allograft transplantation (MAT).
  • To provide quantitative evidence on factors influencing MAT success rates.
  • To inform clinical practice regarding patient risk stratification for MAT.

Main Methods:

  • A systematic review and meta-analysis of studies on MAT graft failure.
  • Searched PubMed, Ovid/Medline, and Cochrane databases up to October 2021.
  • Employed random-effects models to calculate odds ratios (ORs) for identified risk factors.

Main Results:

  • Included 17 studies with 2184 patients; overall failure prevalence was 17.8%.
  • Severe cartilage damage (International Cartilage Regeneration & Joint Preservation Society grade >3a) was a significant risk factor for MAT failure (OR, 5.32).
  • No significant association found between patient sex (OR, 2.16) or MAT laterality (OR, 1.11) and graft failure.

Conclusions:

  • Strong evidence indicates that the degree of preoperative cartilage damage is a key risk factor for MAT graft failure.
  • Evidence regarding the influence of patient sex and transplant laterality on MAT failure remains inconclusive.
  • Further research may clarify the role of other potential risk factors in MAT outcomes.