Return to Sport After Meniscal Allograft Transplantation in Collegiate and Professional Athletes

There is limited literature evaluating return to sport (RTS) and clinical outcomes after meniscal allograft transplantation (MAT) in high-level athletes, particularly those at collegiate and professional levels.

Collegiate and professional athletes undergoing MAT would demonstrate a >50% RTS rate at the preinjury level and report high satisfaction at a minimum 2-year follow-up.

Retrospective case series; Level of evidence, 4.

A retrospective review was conducted to evaluate RTS after MAT in collegiate and professional athletes. Athletes who underwent MAT between 2010 and 2023 with a preoperative intent to return to sport were identified and contacted to complete a standardized RTS survey. Patient-reported outcome scores, including those for the International Knee Documentation Committee (IKDC) and Knee injury and Osteoarthritis Outcome Score (KOOS), were collected at a minimum of 2 years postoperatively. RTS at the preinjury level, patient-reported outcome scores, reoperations, and failure rates were compared between athletes who returned and those who did not. Statistical analysis included the Mann-Whitney U, chi-square, and Fisher exact tests.

A total of 17 patients (mean age, 23.8 years; 10 male [58.8%]) were included: 13 collegiate athletes and 4 professional athletes. There were 8 athletes (47.1%) who returned to their preinjury level of competition at a mean of 12.4 months. Athletes who returned had significantly higher KOOS Sport (78.8 ± 6.3 vs 52.5 ± 19.3, respectively; P = .027) and KOOS Quality of Life (86.0 ± 9.5 vs 47.7 ± 31.5, respectively; P = .042) subscores than those who did not. While reoperations were common (10/17 [58.8%]), reoperation (50.0% RTS vs 66.7% no RTS; P > .99) and failure (11.8%) rates did not differ between groups. Overall, 75.0% of athletes indicated that they would undergo MAT again. Concomitant bone marrow aspirate concentrate, harvested from the proximal tibia and injected intraoperatively, was more frequently applied in athletes who returned (62.5% vs 11.1%, respectively; P = .0498). The primary reason for not returning was surgeon advice against further participation.

Among collegiate and professional athletes with a preoperative intent to return to sport, 47.1% successfully returned to their preinjury level of competition after MAT. The principal reason that an athlete did not return to sport was surgeon advice to discontinue participation. A reoperation in this cohort was common, although the rates of reoperations and clinical failure did not significantly differ between athletes who returned to sport and those who did not. Satisfaction rates after MAT remained high across both groups.