Editorial Commentary: Medial and Lateral Meniscus Allografts Using Bone Plug Fixation in Patients Without Advanced Arthritis Have 80% Positive Outcomes at 10 Years.

Abstract

Meniscal allograft transplantation (MAT) for symptomatic knees after meniscectomy decreases pain and often improves function, but it does not replicate a normal meniscus. The ability of MAT to delay arthritic changes is an ongoing area of study, and it is known that outcomes and graft survivorship deteriorate with longer follow-up. Recommended indications are symptomatic patients after meniscectomy with mild (or at most moderate) degenerative changes and absence of (or surgically corrected) associated malalignment or ligament deficiency. When these indications are followed, 80% of patients improve, with survivorship of 83% at 10 years and 56.2% at 20 years. Medial or lateral MAT shows no difference with respect to graft survivorship or patient-reported outcome measures. Meniscus allografts fixed with bone have less graft extrusion than soft tissue fixation alone. While MAT can be beneficial in an arthritic knee in the short term, the survivorship in knees with advanced arthritis is much smaller, with an extensive rehabilitation requirement, and there is a limited supply of meniscal allograft tissue.