Isolated meniscal allograft transplantation with suture-based fixation of a bone bridge: 15 cases with a 2-year minimum follow-up

BACKGROUND Despite satisfactory results, controversy remains on whether meniscal allograft transplantation (MAT) prevents or even slows the progression of cartilage degeneration in a previously meniscectomized compartment. AIM To evaluate patient reported outcomes at various time points in patients who underwent an isolated MAT using a bone-block technique with suture-based bony fixation. METHODS This case series includes seventeen patients with history of meniscectomy and corresponding compartmental knee pain that were treated with isolated MAT performed by a single orthopedic sports medicine surgeon. Patients were excluded if they did not have 2 years of follow up. Validated surveys specific to knee pain and function were utilized to compare patient-reported outcomes pre-operatively, 6 months, 1 year, and final follow-up. RESULTS Fifteen of 17 patients treated with MAT were evaluated at a minimum of 2 years (mean 4.7 years) of follow-up. Mean patient age was 22.2 ± 10.7 (14-56) years. There were 8 females (53%) and 7 males (47%) included in the statistical analysis. 13 patients had lateral transplants (87%) and 2 had medial transplants (13%). The reoperation rate was 13%; however, no patients required revision MAT or arthroplasty and graft survival was 100%. Average patient reported pain severity score, pain frequency score, and scores from 9 validated knee surveys were significantly improved at 6 months, 1 year, and final follow up compared to pre-operative baseline (P < 0.05). CONCLUSION Despite some limitations, meniscus transplantation with suture-based bone bridge fixation resulted in reliable improvements in knee pain and function at a minimum of 2 years of follow-up. Our study demonstrated 100% graft survival with low complication rates (13.3%). Suture fixation of the transplanted bone block in MAT is a viable technique with excellent clinical outcomes.