Initial Outcomes following Fresh Meniscus Allograft Transplantation in the Knee.

Autor:	Cook JL; Thompson Laboratory for Regenerative Orthopaedics, MU Joint Preservation Center, Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri., Stannard JP; Thompson Laboratory for Regenerative Orthopaedics, MU Joint Preservation Center, Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri., Rucinski KJ; Thompson Laboratory for Regenerative Orthopaedics, MU Joint Preservation Center, Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri., Nuelle CW; Thompson Laboratory for Regenerative Orthopaedics, MU Joint Preservation Center, Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri., Crecelius CR; Thompson Laboratory for Regenerative Orthopaedics, MU Joint Preservation Center, Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri., Cook CR; Thompson Laboratory for Regenerative Orthopaedics, MU Joint Preservation Center, Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri., Ma R; Thompson Laboratory for Regenerative Orthopaedics, MU Joint Preservation Center, Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri.
Jazyk:	angličtina
Zdroj:	The journal of knee surgery [J Knee Surg] 2024 Sep 09. Date of Electronic Publication: 2024 Sep 09.
DOI:	10.1055/a-2389-9001
Abstrakt:	Based on recent evidence-based advances in meniscus allograft transplantation (MAT), fresh (viable) meniscus allografts have potential for mitigating key risk factors associated with MAT failure, and preclinical and clinical data have verified the safety of fresh meniscus allografts as well as possible efficacy advantages compared with fresh-frozen meniscus allografts. The objective of this study was to prospectively assess clinical outcomes for the initial cohort of patients undergoing MAT using fresh meniscus allografts at our center. Patients who were prospectively enrolled in a dedicated registry were included for analyses when they had undergone primary MAT using a fresh meniscus allograft for treatment of medial and/or lateral meniscus deficiency with at least 1-year follow-up data recorded. Forty-five patients with a mean final follow-up of 47.8 months (range = 12-90 months) were analyzed. The mean patient age was 30.7 years (range = 15-60 years), mean body mass index (BMI) was 29.7 kg/m 2 (range = 19-48 kg/m 2 ), and 14 patients (31%) were females. In total, 28 medial, 13 lateral, and 4 combined medial and lateral MATs with 23 concurrent ligament reconstructions and 2 concurrent osteotomies were included. No local or systemic adverse events or complications related to MAT were reported for any patient in the study. Treatment success rate for all patients combined was 91.1% with three patients requiring MAT revision and one patient requiring arthroplasty. Treatment failures occurred 8 to 34 months after MAT and all involved the medial meniscus. None of the variables assessed were significantly different between treatment success and treatment failure cohorts. Taken together, the data suggest that the use of fresh (viable) meniscus allografts can be considered a safe and effective option for medial and lateral MAT. When transplanted using double bone plug suspensory fixation with meniscotibial ligament reconstruction, fresh MATs were associated with a 91% success rate, absence of local or systemic adverse events or complications, and statistically significant and clinically meaningful improvements in patient-reported measures of pain and function at a mean of 4 years postoperatively. Competing Interests: The authors report the following conflicts:J.L.C. reports the following: AANA: Research support; AO Trauma: Research support; Advanced Research Projects Agency for Health: Research support; Arthrex, Inc: IP royalties; Paid consultant; Research support; Boehringer Ingelheim: Paid consultant; Collagen Matrix Inc: Paid consultant; Research support; GE Healthcare: Research support; Journal of Knee Surgery: Editorial or governing board; Midwest Transplant Network: Board or committee member; Musculoskeletal Transplant Foundation/MTF Biologics: Board or committee member; IP royalties; Research support; National Institutes of Health (NIAMS & NICHD): Research support; OREF: Research support; PCORI: Research support; Thieme: Publishing royalties, financial or material support; Trupanion: Paid consultant; U.S. Department of Defense: Research support.J.P.S. reports the following: Arthrex, Inc: Paid consultant; Research support, DePuy, A Johnson & Johnson Company: Paid consultant; Journal of Knee Surgery: Editorial or governing board; National Institutes of Health (NIAMS & NICHD): Research support; Orthopedic Designs North America: Paid consultant; Smith & Nephew: Paid consultant; Thieme: Publishing royalties, financial or material support; U.S. Department of Defense: Research support.K.R. has no conflicts to report.C.N. reports the following: AAOS: Board or committee member; American Orthopaedic Society for Sports Medicine: Board or committee member; AO Foundation: Other financial or material support; Arthrex, Inc: Paid presenter or speaker; Arthroscopy: Editorial or governing board; Publishing royalties, financial or material support; Arthroscopy Association of North America: Board or committee member; Guidepoint Consulting: Paid consultant; Vericel, Inc.: Paid presenter or speaker.C.C. has no conflicts to report.C.R.C. reports the following: Arthrex, Inc.: research support, consulting fees and royalties; Zimmer; nonconsulting fees from Arthrex, CONMED Linvatec, and Musculoskeletal Transplant Foundation; and royalties from CONMED Linvatec and Musculoskeletal Transplant Foundation.R.M. reports the following: AAOS: Board or committee member; American College of Sports Medicine: Board or committee member; American Orthopaedic Association: Board or committee member; American Orthopaedic Society for Sports Medicine: Board or committee member; Arthroscopy Association of North America: Board or committee member; Cartiheal: Research support.Johnson & Johnson: Paid consultant; Journal of Bone and Joint Surgery – American: Editorial or governing board; Moximed: Research support; Novocart: Research support; Rugby Research Injury Prevention Group: Board or committee member. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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