Editorial Commentary: Revision Meniscal Allograft Transplantation is a Bridge Option for Appropriately Indicated Patients With Realistic Patient Expectations in the Hands of Experienced Knee Surgeons Able to Perform All Necessary Concomitant Procedures.

Abstract

Primary meniscal allograft transplantation (PMAT) is an effective yet sometimes short-term solution to postmeniscectomy syndrome. Survivorship beyond 10 years can carry a guarded prognosis. Alternatives after failure of PMAT are typically total or unicompartmental arthroplasty, which, depending on desired activity level, can be reasonable options for older patients. However, when faced with younger, otherwise healthy patients, revision meniscal allograft transplantation (RMAT) shows outcomes in appropriately indicated patients when concomitant pathology is also addressed. Patient expectations must be tempered (i.e., they should not expect to achieve an International Knee Documentation Committee score of 70 to 100, but rather 40 to 70 meaning that a patient can function reasonably well in activities of daily living). Thus RMAT is a viable "salvage" or "bridge" option in the hands of experienced high-volume knee surgeons (to ensure meticulous surgical technique and the ability to perform all necessary concomitant procedures). Patients must have appropriate expectations and be appropriately indicated.