Clinical Outcomes of Meniscal Allograft Transplantation With or Without Other Procedures: A Systematic Review and Meta-analysis.
BACKGROUND
While additional procedures correcting accompanying pathological conditions can improve the clinical outcomes of meniscal allograft transplantation (MAT), whether those outcomes are comparable or poorer than those of isolated MAT has yet to be clarified.


PURPOSE
To evaluate whether there is a difference in clinical outcomes between isolated MAT and MAT combined with other procedures (combined MAT).


STUDY DESIGN
Meta-analysis and systematic review.


METHODS
For the comparison of clinical outcomes between isolated MAT and combined MAT, the authors searched MEDLINE, Embase, and the Cochrane Library. Studies that separately reported the clinical outcomes of isolated MAT and combined MAT were included. Clinical outcomes were evaluated in terms of patient-reported outcomes (PROs) and complication, reoperation, survivorship, and failure rates. We conducted a meta-analysis of the PROs that were used in more than 3 studies.


RESULTS
A total of 24 studies were included in this study. In the meta-analysis, no significant differences in Lysholm scores (95% CI, -5.92 to 1.55; P = .25), Tegner activity scores (95% CI, -0.54 to 0.22; P = .41), International Knee Documentation Committee subjective scores (95% CI, -5.67 to 3.37; P = .62), and visual analog scale scores (95% CI, -0.15 to 0.94; P = .16) were observed between isolated MAT and combined MAT. For PROs that were not included in the meta-analysis, most studies reported no significant difference between the 2 groups. As for the survivorship and failure rates, studies showed varying outcomes. Four studies reported that additional procedures did not affect MAT failure or survivorship. However, 3 studies reported that ligament surgery, realignment osteotomy, and osteochondral autograft transfer were risk factors of failure. One study reported that the medial MAT group in which high tibial osteotomy was performed showed a higher survival rate than the isolated medial MAT group.


CONCLUSION
Overall, there seems to be no significant difference between the postoperative PROs in terms of isolated MAT and combined MAT. However, more data are required to verify the effects of osteotomy and cartilage procedures on the clinical outcomes of MAT. We could not draw conclusions about the differences in complication, reoperation, survivorship, and failure rates between the 2 groups because we did not obtain sufficient data.
['Lee|Bum-Sik|BS|', 'Kim|Hyun-Jung|HJ|', 'Lee|Chang-Rack|CR|', 'Bin|Seong-Il|SI|', 'Lee|Dae-Hee|DH|', 'Kim|Na-Jin|NJ|', 'Kim|Chang-Wan|CW|']
D064591:Allografts D006801:Humans D007718:Knee Injuries D007719:Knee Joint D008592:Menisci, Tibial D010027:Osteotomy D000071066:Patient Reported Outcome Measures D012086:Reoperation
outcomes meniscal allograft transplantation systematic review meta-analysis