How to decrease graft extrusion following lateral meniscal allograft transplantation
Nam-Hong Choi
Department of Orthopedic Surgery, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
Correspondence to: Nam-Hong Choi, https://orcid.org/0009-0000-0688-4191
Department of Orthopedic Surgery, Nowon Eulji Medical Center, Eulji University, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea.
Tel: +82-2-970-8260, Fax: +82-2-970-8429, E-mail: cnh2406@yahoo.com
Department of Orthopedic Surgery, Nowon Eulji Medical Center, Eulji University, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Korea.
Tel: +82-2-970-8260, Fax: +82-2-970-8429, E-mail: cnh2406@yahoo.com
Received August 26, 2022; Revised October 25, 2022; Accepted February 10, 2023.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
- Abstract
- Meniscal allograft transplantation (MAT) is a viable treatment option for patients with meniscal deficiency. However, allograft extrusion is commonly observed after meniscal transplantation. Extrusion of the meniscus is biomechanically harmful and can be associated with cartilage volume loss, a decrease in cartilage thickness, and an increase in denuded bone in the affected compartment of the knee. Therefore, arthroscopic surgeons need to give their best effort to prevent allograft extrusion after MAT. In this review, anatomical and technical perspectives to decrease extrusion following lateral MAT are discussed.
- Keywords : Meniscus; Transplantation
- References
- Vundelinckx B, Vanlauwe J, Bellemans J. Long-term subjective, clinical, and radiographic outcome evaluation of meniscal allograft transplantation in the knee. Am J Sports Med 2014; 42:1592-9.
- Wang DY, Zhang B, Li YZ, Meng XY, Jiang D, Yu JK. The long-term chondroprotective effect of meniscal allograft transplant: a 10-to 14-year follow-up study. Am J Sports Med 2022;50:128-37.
- Lee DH, Kim JM, Lee BS, Kim KA, Bin SI. Greater axial trough obliquity increases the risk of graft extrusion in lateral meniscus allograft transplantation. Am J Sports Med 2012;40:1597-605.
- Verdonk PC, Verstraete KL, Almqvist KF, et al. Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations. Knee Surg Sports Traumatol Arthrosc 2006;14:694-706.
- Sharma L, Eckstein F, Song J, et al. Relationship of meniscal damage, meniscal extrusion, malalignment, and joint laxity to subsequent cartilage loss in osteoarthritic knees. Arthritis Rheum 2008;58:1716-26.
- Lee SM, Bin SI, Kim JM, et al. Long-term outcomes of meniscal allograft transplantation with and without extrusion: mean 12.3-year follow-up study. Am J Sports Med 2019;47:815-21.
- Kim JH, Bin SI, Lee BS, et al. Nonanatomic horn position increases risk of early graft failures after lateral meniscal allograft transplantation. Am J Sports Med 2018;46:3407-14.
- Siebold R, Schuhmacher P, Fernandez F, et al. Flat midsubstance of the anterior cruciate ligament with tibial “C”-shaped insertion site. Knee Surg Sports Traumatol Arthrosc 2015;23:3136-42.
- LaPrade CM, Ellman MB, Rasmussen MT, et al. Anatomy of the anterior root attachments of the medial and lateral menisci: a quantitative analysis. Am J Sports Med 2014;42:2386-92.
- Steineman BD, Moulton SG, Haut Donahue TL, et al. Overlap between anterior cruciate ligament and anterolateral meniscal root insertions: a scanning electron microscopy study. Am J Sports Med 2017;45:362-8.
- Lee SR, Kim JG, Nam SW. The tips and pitfalls of meniscus allograft transplantation. Knee Surg Relat Res 2012;24:137-45.
- Choi NH, Hwangbo BH, Kang HK, Yang BS, Victoroff BN. Accuracy of the arthroscopic location of the center of the anterior horn during lateral meniscal allograft transplantation. Orthop J Sports Med 2022;10:23259671221089250.
- Johannsen AM, Civitarese DM, Padalecki JR, Goldsmith MT, Wijdicks CA, LaPrade RF. Qualitative and quantitative anatomic analysis of the posterior root attachments of the medial and lateral menisci. Am J Sports Med 2012;40:2342-7.
- Ren AH, Zheng ZZ, Shang Y, Tian CY. An anatomical study of normal meniscal roots with isotropic 3D MRI at 3T. Eur J Radiol 2012;81:e783-8.
- Choi NH, Yang BS, Lee SY, Lee CC, Lee CY, Victoroff BN. Comparison of the insertion of the posterior horn of the lateral meniscus: discoid versus non-discoid. Knee Surg Sports Traumatol Arthrosc 2017;25:397-402.
- Choi NH, Yoo SY, Victoroff BN. Position of the bony bridge of lateral meniscal transplants can affect meniscal extrusion. Am J Sports Med 2011;39:1955-9.
- Lee DH, Kim JM, Jeon JH, Cha EJ, Bin SI. Effect of sagittal allograft position on coronal extrusion in lateral meniscus allograft transplantation. Arthroscopy 2015;31:266-74.
- Yoon JR, Kim TS, Lee YM, Jang HW, Kim YC, Yang JH. Transpatellar approach in lateral meniscal allograft transplantation using the keyhole method: can we prevent graft extrusion? Knee Surg Sports Traumatol Arthrosc 2011;19:214-7.
- Choi NH, Choi JK, Yang BS, Lee DH, Victoroff BN. Lateral meniscal allograft transplant via a medial approach leads to less extrusion. Am J Sports Med 2017;45:2791-6.
- Choi NH, Yang BS, Lee DM, Lee JS, Victoroff BN. Correlation between anatomic landmarks and bony trough position in lateral meniscal allograft transplant. Orthop J Sports Med 2022; 10:23259671221117531.
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