Meniscal allograft transplantation in The Netherlands: long-term survival, patient-reported outcomes, and their associat
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Meniscal allograft transplantation in The Netherlands: long‑term survival, patient‑reported outcomes, and their association with preoperative complaints and interventions Robert J. P. van der Wal1 · Marc J. Nieuwenhuijse1 · Reinier W. A. Spek2 · Bregje J. W. Thomassen2 · Ewoud R. A. van Arkel2 · Rob. G. H. H. Nelissen1 Received: 2 April 2020 / Accepted: 10 September 2020 © The Author(s) 2020
Abstract Purpose Evaluation of survival of meniscal allograft transplantation (MAT) and postoperative patient-reported outcome (PRO), and their association with prior interventions of the knee. Methods A prospective consecutive study of 109 consecutive patients who had an arthroscopic meniscal allograft transplantation (MAT) between 1999 and 2017 by a single surgeon. Patients were assessed with KOOS scores, preoperative and after a minimal follow-up of 2 years. Furthermore, two anchor questions (whether expectations were met and overall satisfaction, on a five-point Likert scale) were asked. Additionally, prior interventions to MAT were evaluated. Results Prior to MAT, patients had undergone an average of 2.8 (range 1–14) of surgical procedures of the knee. Overall, mean allograft survival was 16.1 years (95% CI 14.8–17.5 years). Higher age at surgery was associated with lower MAT survival: hazard ratio for MAT failure was 1.19 per year increase (95% CI 1.04 to 1.36, p = 0.009). At 4.5 years (IQR, 2–9) of follow-up, all KOOS score were still improved compared to baseline. Age below 35 years, simultaneous anterior cruciate ligament reconstruction and number of knee surgeries before MAT were associated with lower KOOS scores. Overall patient expectations and overall satisfaction after MAT were not associated with preoperative patient characteristics nor with the number or kind of preoperative interventions. Conclusion Meniscal allograft transplantation has a good overall survival with a clinically relevant improvement. Both meniscal allograft survival and PRO were associated with age. PRO was lower in patients younger than 35 years at time of MAT and meniscal allograft survival was worse in patients older than 50 years. PRO was associated with preoperative patient characteristics and number of surgical procedures prior to MAT. All patients reported improved postoperative satisfaction and met expectations after MAT, both independent of the preoperative history of knee interventions. Level of evidence Level III. Trial registration Medical ethical review board (METC) number: 17–104 (7 August 2017). Dutch Trial Register (NTR) number: NTR6630 (4 July 2017). Keywords Meniscal allograft transplantation · Survival · Patient history · Patient-reported outcome · Satisfaction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00167-020-06276-y) contains supplementary material, which is available to authorized users. * Robert J. P. van der Wal [email protected] 1
Department of Orthopaedics, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2333 ZA Leiden
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