Returning to competitive sport after meniscal allograft transplant is associated with sustained graft survival and improved patient-reported outcomes.

Abstract

Meniscal allograft transplantation (MAT) aims to restore function without pain. Guidance on return-to-sport remains unclear due to concerns about re-injury. This study compared failure rates, outcomes, and complications in patients who resumed competitive sport after MAT with those who did not. A retrospective review of a prospectively maintained MAT cohort was performed. Patients achieving a postoperative Tegner score ≥8 were classified as return-to-sport. Kaplan-Meier analysis assessed failure rates. Postoperative International Knee Documentation Committee (IKDC), Tegner, Knee Injury and Osteoarthritis Outcome Score, and Lysholm scores were compared between groups. Data from 422 patients were analysed; 51 returned to competitive sport. Mean age was 28.0 (8.1) in the return group and 30.1 (9.4) in the non-return group (p = 0.09). Five-year survival probability was higher in the return to sport group (94.1% vs. 88.6%, p < 0.001). Patient-reported outcomes were consistently superior, with mean IKDC at 10 years of 79.7 (8.2) versus 61.0 (20.8) (p < 0.001). Return to competitive sport after MAT is associated with excellent graft survival and superior long-term outcomes, with no evidence of increased failure. These results support safe return to high-level sport and provide important counselling information for postmeniscectomy patients considering transplantation. Level IV.