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Meniscal allograft transplantation shows a mismatch between anatomic and clinical failures

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Abstract
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Abstract
Purpose Clinical results of meniscal allograft transplantation (MAT) are not always consistent with graft status. This study
aimed to investigate (1) the degree and pattern of mismatch between anatomic and clinical failures in MAT and (2) preoperative
factors associated with the mismatch.
Methods Two hundred and ninety-eight consecutive patients who underwent primary medial or lateral MAT during 2004?
2015 were reviewed. Anatomic failure was defined as an allograft showing meniscal tear involving > 50% of the graft or
unstable peripheral rim. Clinical failure included poor Lysholm score of < 65 and any requirement for re-operations such
as arthroplasty, realignment osteotomy, revision MAT, and meniscectomy (more than 50% of the graft or to the zone of
meniscocapsular junction). Failure cases were categorised according to the type of failure as follows: (1) type 1, anatomic
failure followed by clinical failure; (2) type 2, anatomic failure did not lead to clinical failure; and (3) type 3, clinical failure
without anatomic failure. Preoperative factors including age, sex, body mass index, MAT compartment, time from previous
meniscectomy, alignment, cartilage status, and accompanying procedures were analysed according to the failure type.
Results Forty (13.4%) patients showed anatomical or clinical failure during the median (25th?75th percentile) follow-up
duration of 47 (30?72) months (range 24?178 months). Eleven (3.7%) patients showed both anatomical and clinical failure
(type 1 failure). Seventeen (5.7%) patients showed anatomic failure that did not lead to clinical failure (type 2 failure).
Twelve (4.0%) patients failed clinically without meniscal tear (> 50% of graft) or unstable peripheral rim (type 3 failure).
Comparative analyses among failure types found a significant difference in MAT compartment (p = 0.01). In particular, the
incidence of type 3 failure was higher in medial than in lateral MAT (p = 0.003).
Conclusion A notable number of failure cases of MAT showed a mismatch between anatomic and clinical failures. Even with
anatomic failure, MAT did not always lead to poor clinical scores or re-operations, whereas MAT could have poor results
without substantial allograft problems. Therefore, both anatomic and clinical aspects should be considered when evaluating
MAT. In particular, type 3 failure occurred more frequently in medial than in lateral MAT.
Author(s)
김종민빈성일송주호이범식
Issued Date
2021
Type
Article
Keyword
Anatomic failureClinical failureMeniscal allograft transplantationPatient-reported outcome
DOI
10.1007/s00167-021-06713-6
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8712
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2568595645&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Meniscal%20allograft%20transplantation%20shows%20a%20mismatch%20between%20anatomic%20and%20clinical%20failures&amp;offset=0&amp;pcAvailability=true
Publisher
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
Location
미국
Language
영어
ISSN
0942-2056
Citation Volume
1
Citation Number
1
Citation Start Page
1
Citation End Page
6
Appears in Collections:
Medicine > Medicine
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