A systematic review of the incidence and clinical

Authors: Frank R Noyes Sue D BarberWestin

Publish Date: 2014/09/24

Volume: 23, Issue: 1, Pages: 290-302

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Abstract

A systematic search was performed using PubMed and Cochrane online databases Inclusionary criteria were English language clinical trials of meniscus transplantation published from 1984 to 2014 and meniscus extrusion measured on magnetic resonance imaging MRITwentythree studies were included in which 814 menisci were implanted into 803 patients MRIs were obtained from 2 days to 10 years postoperatively Eighteen studies used freshfrozen meniscus transplants implanted with bone n = 612 or suture fixation n = 116 four studies cryopreserved transplants and one irradiated transplants Three measurements assessed extrusion absolute millimeters of extrusion 0–88 mm relative percentage of extrusion 0–100  and the percent of transplants that were extruded 0–100  Relationships between transplant extrusion and clinical rating scales joint space narrowing on standing radiographs and arthrosis progression were inconclusive Nonanatomic placement of lateral meniscus transplants and suture fixation of medial and lateral transplants were associated with greater extrusion in two studiesInconsistencies among studies prevent conclusions regarding the incidence and clinical significance of meniscus transplant extrusion Even so the short to midterm results were encouraging for knee function with daily activities and low rates of failure requiring transplant removal A postoperative MRI showing more than 3mm extrusion occurring in some studies suggested technique and/or implant sizing problems that required correction Future studies should report absolute transplant extrusion relative percent of extrusion percent of transplant within the tibiofemoral compartment and the percent of transplants that are extruded

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