Meniscal Allograft Transplantation Is an Effective Treatment in Patients Older Than 50 Years but Yields Inferior Results Compared With Younger Patients: A Case-Control Study.


Journal

Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
ISSN: 1526-3231
Titre abrégé: Arthroscopy
Pays: United States
ID NLM: 8506498

Informations de publication

Date de publication:
08 2019
Historique:
received: 29 08 2018
revised: 15 03 2019
accepted: 21 03 2019
entrez: 10 8 2019
pubmed: 10 8 2019
medline: 21 4 2020
Statut: ppublish

Résumé

To evaluate the influence of age on midterm clinical outcomes and failures of meniscal allograft transplantation (MAT), aiming at investigating the efficacy of MAT in patients older than 50 years. In this case-control study, data on patients older than 50 years (older MAT [O-MAT] group) with at least 5 years of follow-up and a matched-pair group of patients younger than 30 years of age (younger MAT [Y-MAT] group) were extracted from a database of MAT procedures, performed with arthroscopic implantation of fresh-frozen meniscal allograft without bone plugs. A matched-pair comparative analysis of midterm results and survival between 26 O-MAT patients and 26 Y-MAT patients was performed at a mean follow-up of 7.3 ± 2.2 years. All the clinical scores significantly improved from the baseline values in both the O-MAT and Y-MAT groups although with significantly lower scores in the O-MAT group. Two-thirds of O-MAT patients were able to return to a recreational level of sports activity. Only 2 patients in the O-MAT group underwent knee replacement, but the overall failure rate, also considering a clinical criterion, was 31% in the O-MAT group and 15% in the Y-MAT group (P = .3244). The mean survival time free from replacement or graft removal was 11.6 years in the O-MAT group and 12.3 years in the Y-MAT group (P = .691). MAT is able to provide symptom relief and functional improvement at midterm follow-up in patients older than 50 years although with inferior results and a higher failure rate compared with those younger than 30 years. MAT can be considered a viable option to treat patients older than 50 years. Level III, case-control study.

Identifiants

pubmed: 31395185
pii: S0749-8063(19)30308-1
doi: 10.1016/j.arthro.2019.03.048
pii:
doi:

Types de publication

Comparative Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2448-2458

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019. Published by Elsevier Inc.

Auteurs

Stefano Zaffagnini (S)

II Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Alberto Grassi (A)

II Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Luca Macchiarola (L)

II Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Federico Stefanelli (F)

II Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Vito Coco (V)

II Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Maurilio Marcacci (M)

Department of Biomedical Sciences, Humanitas University, Humanitas Clinical and Research Center, Milan, Italy.

Luca Andriolo (L)

II Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. Electronic address: lucas.andriolo@gmail.com.

Giuseppe Filardo (G)

Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

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Classifications MeSH