This prospective Level IV cohort followed 42 viable meniscal allografts in 41 meniscectomized patients for a minimum of 10 years. It asked whether transplantation gives durable pain relief and function, and whether it protects cartilage. Outcomes were tracked clinically (modified HSS, KOOS) plus standing radiographs and MRI.
The core teaching point: meniscal allograft transplantation is a salvage operation for the young, symptomatic, meniscectomized knee that is too early for arthroplasty. It buys durable pain relief and function, not a normal knee.
Build your mental model around patient selection. Focal cartilage lesions are acceptable, but extended grade IV disease is a contraindication because the graft cannot protect bare, generalized bone.
Alignment drives outcome. When you see a varus knee with medial meniscal deficiency, the graft alone will be overloaded, so pair it with a high tibial osteotomy to unload the compartment. Similarly, an ACL-deficient knee needs stabilization first.
The chondroprotection signal (41% with no joint space narrowing, 35% with no MRI progression) is encouraging but uncontrolled, so counsel patients honestly. Finally, follow these patients clinically. MRI extrusion and grade III signal are common and do not track with symptoms.
This prospective Level IV cohort followed 42 viable meniscal allografts in 41 meniscectomized patients for a minimum of 10 years. It asked whether transplantation gives durable pain relief and function, and whether it protects cartilage. Outcomes were tracked clinically (modified HSS, KOOS) plus standing radiographs and MRI.
The core teaching point: meniscal allograft transplantation is a salvage operation for the young, symptomatic, meniscectomized knee that is too early for arthroplasty. It buys durable pain relief and function, not a normal knee.
Build your mental model around patient selection. Focal cartilage lesions are acceptable, but extended grade IV disease is a contraindication because the graft cannot protect bare, generalized bone.
Alignment drives outcome. When you see a varus knee with medial meniscal deficiency, the graft alone will be overloaded, so pair it with a high tibial osteotomy to unload the compartment. Similarly, an ACL-deficient knee needs stabilization first.
The chondroprotection signal (41% with no joint space narrowing, 35% with no MRI progression) is encouraging but uncontrolled, so counsel patients honestly. Finally, follow these patients clinically. MRI extrusion and grade III signal are common and do not track with symptoms.