Initial clinical outcomes comparing frozen versus fresh meniscus allograft transplants.

Abstract

To evaluate initial clinical outcomes using fresh meniscal allografts with high cell viability at transplantation time and meniscotibial ligament (MTL) reconstruction (Fresh) in comparison to standard fresh-frozen (Frozen) meniscus allograft transplantation (MAT). Patients treated for medial and/or lateral meniscal deficiency using either Fresh or Frozen MAT with minimum of 1-year follow-up were identified from a prospective registry. Patient demographics, prior surgeries, MAT surgery data, complications, revisions, and failures were documented. Functional outcome scores were collected preoperatively, and 6 months and yearly after surgery and radiographic joint space measurements were performed. Treatment cohorts were compared for statistically significant (P < 0.005) differences using t-Tests and Fisher's exact tests. Twenty-seven patients (14 Fresh, 13 Frozen) met inclusion criteria and showed comparable characteristics. For Fresh MAT + MTL, 10 medial, two lateral, and two medial + lateral MAT were performed. For Frozen MAT, nine medial, and four lateral MAT were performed. There was significantly more improvement in the Fresh cohort compared to the Frozen cohort for VAS pain (P = 0.014), PROMIS Physical Function (P = 0.036) and Single Assessment Numeric Evaluation (P = 0.033) from preoperatively to 2 years postoperatively. Tegner Activity Scale and PROMIS Mobility score showed no significant differences. The International Knee Documentation Committee score revealed a clinically meaningful change for the Fresh group. Radiographic measurements showed no significant differences between groups. There were two Fresh MAT + MTL revisions and one conversion to TKA in each cohort. Fresh MAT + MTL is safe and associated with potential advantages with respect to initial pain relief and function compared to standard frozen MAT.