Editorial Commentary: Meniscal Allograft Transplantation Is a Powerful Tool for Treating Pain for Properly Indicated Patients, but Ability to Prevent Osteoarthritis Progression Remains Undetermined.

Abstract

In well-indicated patients, meniscal allograft transplantation (MAT) survivorship can approach 80% to 90% at 10 years and 50% to 60% at 15 years, although these studies have included mostly younger patients (mean ages 25-30 years). Evidence-based indications for MAT are symptomatic meniscal deficiency in the absence of uncorrected osteoarthritis and malalignment in the young, active patient. The definition of young and active continues to evolve as demands of an aging population grow, and MAT has been performed with favorable outcomes in those over 40 and even 50 years old. However, MAT is not a solution to prevent arthritic progression, and the results in those with osteoarthritis have been less predictable in nature. No studies to date have demonstrated a definable delay to arthroplasty with the use of MAT as compared to the natural history of osteoarthritis. We recommend a focusing on alleviating symptoms in properly indicated patients and considering concomitant procedures that are performed to provide an optimal environment for MAT, such as realignment in the setting of >5° of varus (or valgus) or cartilage repair procedures that have been reproducibly performed by a number of authors to date in combination with MAT.