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Long-term study shows benefits of meniscal transplant

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Most patients under the age of 50 with a torn or severely damaged meniscus benefit from reduced pain and improved knee function following transplant surgery, according to a study in the Journal of Bone and Joint Surgery.

The long-term U.S. study suggests that, even though many patients require further surgery within ten years, the procedure is still justified because of the significant improvements seen.

For the study, 40 cryopreserved menisci were implanted into 38 patients, none of whom had arthritis. The patients were followed for a mean post-operative time of 11 years.

The researchers found that the mean time to failure was 8.2 years for medial transplants and 7.6 years for lateral transplants. Significant improvements were recorded for pain, swelling, the patient´s perception of the knee condition, walking, stair-climbing and squatting.

At ten years 63% of meniscal transplants were still viable, and only 11% of patients with successful transplants had pain when engaging in daily activities. What´s more, nearly three-quarters (72%) were able to take part in low-impact sports such as cycling and swimming.

In patients who required additional surgery, the meniscal transplants lasted between around 7-8 years after surgery, depending on which side of the knee the meniscus transplant was located.

The study authors noted that, although the data indicates that the majority of cryopreserved meniscal transplants may fail in the long term, the resolution of symptoms and improvement in function for several years justifies the procedure in young patients who are symptomatic after meniscectomy.

“This data provides surgeons with reasonable percentages that encourage delaying additional major knee surgeries related to a damaged meniscus,” commented lead study author Dr. Frank R. Noyes.

Patients should, however, be advised that the procedure is not curative in the long term and additional surgery will most likely be necessary, Dr. Noyes concluded.

http://newsroom.aaos.org/article_display.cfm?article_id=4211

http://jbjs.org/content/97/15/1209