Meniscal Allograft Transplantation in the Adolescent Population.
PURPOSE: To report the results of meniscal allograft transplantation (MAT) with minimum 2-year follow-up in an active adolescent population. METHODS: After institutional review board approval, all patients aged 16 years or younger who underwent MAT and had more than 2 years' clinical follow-up were identified from a prospectively collected database. Demographic data were collected and summary statistics calculated. Functional outcome scores were collected preoperatively and at 6 months, 1 year, 2 years, and final follow-up. Differences between scores at each time point were calculated using a mixed-model repeated-measures analysis of variance. All prior procedures and reoperations were documented. RESULTS: Thirty-seven MAT procedures were performed in 36 children (84% lateral and 16% medial). For 32 of these procedures (86%), the patients met the inclusion criteria with minimum 2-year follow-up. The mean age was 15.4 ± 1.04 years (range, 13 to 16 years). All patients had undergone prior knee surgery. Of the 32 patients, 23 (72%) were girls and 9 (28%) were boys. Eleven patients had open physes. Forty-eight percent of patients underwent concomitant procedures, mainly for chondral defects. The mean length of clinical follow-up was 7.2 ± 3.2 years (range, 2 to 15 years). MAT resulted in significant improvements in the Knee Injury and Osteoarthritis Outcome Score, Lysholm score, International Knee Documentation Committee subjective score, Western Ontario and McMaster Universities Osteoarthritis Index pain score, Western Ontario and McMaster Universities Osteoarthritis Index function score, and Short Form 12 physical score. After MAT, 7 patients (22%) underwent 8 surgical procedures, most of which were for chondral disease. The meniscal reoperation rate was 6%. No revision MAT procedures were required. No angular deformities or limb-length inequalities were reported. CONCLUSIONS: MAT resulted in predictable improvements in functional outcomes in the adolescent population. The meniscal reoperation rate was low (6%), no revision MAT procedures were required, and no growth complications were reported. Chondral disease remains the primary reason for reoperation after MAT. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Riboh, JC; Tilton, AK; Cvetanovich, GL; Campbell, KA; Cole, BJ
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