Isolated meniscal allograft transplantation with suture-based fixation of a bone bridge: 15 cases with a 2-year minimum follow-up

Table 1 Indications and contraindications for isolated meniscal allograft transplantation

BMI < 35 kg/m2
Normal coronal and sagittal alignment of the knee
Normal ligamentous stability
No articular cartilage lesions in the compartment with corresponding pathologic meniscus
Patient willing and able to comply with all postoperative restrictions and rehabilitation protocols
Patient with realistic post-surgical expectations

BMI: Body mass index.

Table 2 Post-operative rehabilitation protocol for isolated meniscal allograft transplantation

Post-operative rehabilitation protocol
Begin physical therapy 3-5 days after surgery
Touch down weight bearing to 25% partial weight bearing is allowed for 6 weeks. Full weight bearing at 6 weeks. Upon initiation of full weight bearing an unloader brace is used to off-load the surgical compartment
While ambulating, the knee is locked in extension with a brace for 6 weeks
Range of motion from 0-45 degrees until 2 weeks post-operatively
Range of motion from 0-60 degrees from post-operative weeks 2-4
Range of motion from 0-90 degrees from post-operative weeks 4-6
Advance to range of motion as tolerated after post-operative week 6, avoiding forced flexion for 3-4 months
Return to work for a sedentary job can be as early as one week post-operatively. For strenuous work, it will take approximately 3-4 months
Low-impact exercises are allowed at 8 weeks with running after 6 months. Light to moderate sport is allowed at 6 months to 9 months with strenuous sport not recommended. Each case is unique and modifying return to work and sport to a certain degree is necessary for every patient

Table 3 Individual patient characteristics

Patient	Age (years)	Sex	Laterality	Need for follow up procedure
1	21	Female	Lateral	No
2	35	Female	Lateral	No
3	56	Male	Medial	No
4	14	Male	Lateral	No
5	14	Male	Lateral	No
6	17	Male	Lateral	No
7	17	Female	Lateral	No
8	23	Female	Lateral	No
9	19	Male	Lateral	No
10	25	Female	Lateral	Yes (meniscal re-tear)
11	19	Female	Medial	Yes (arthrofibrosis)
12	20	Female	Lateral	No
13	17	Male	Lateral	No
14	19	Male	Lateral	No
15	17	Female	Lateral	No

Table 4 Patient demographic summation

Patients (n)	15
Average age (years)	22.2 ± 10.7 (14-56)
Sex	Female 53% (8/15), male 47% (7/15)
Laterality	Lateral 87% (13/15), medial 13% (2/15)
Revision rate	13% (2/15)
Avg follow up	57 months (24-111)

Table 5 Patient reported outcomes and pain scores

	Preop (n = 15)	6 months (n = 15)	P value	1 year (n = 15)	P value	2+ years (average = 4.7 years) (n = 15)	P value
Pain frequency	6.9 ± 2.5	3.2 ± 2.5	P < 0.001	3.1 ± 2.2	P < 0.001	3.4 ± 3.6	P = 0.001
Pain severity	6.2 ± 2.6	3.4 ± 2.5	P = 0.002	3.3 ± 2.9	P < 0.001	2.9 ± 2.5	P < 0.001
IKDC function	37.1 ± 15.7	59.4 ± 17.2	P = 0.001	70.1 ± 22.1	P < 0.001	74.2 ± 17.7	P < 0.001
Lysholm	52.2 ± 20.6	72.5 ± 17.9	P = 0.001	80.1 ± 15.4	P < 0.001	83.1 ± 17.7	P < 0.001
KOOS pain score	53.9 ± 14.2	80.4 ± 15.3	P < 0.001	84.4 ± 15.6	P < 0.001	86.1 ± 15.0	P < 0.001
KOOS symptom	45.7 ± 16.5	68.6 ± 16.8	P = 0.004	82.6 ± 17.8	P < 0.001	82.4 ± 16.3	P < 0.001
KOOS ADL	65.5 ± 18.9	88.4 ± 13.3	P < 0.001	90.7 ± 13.6	P < 0.001	89.4 ± 12.2	P < 0.001
KOOS sport	26.3 ± 25.5	52.1 ± 28.0	P = 0.021	66.0 ± 30.0	P < 0.001	69.7 ± 27.7	P < 0.001
KOOS QoL	30.8 ± 23.9	53.3 ± 18.4	P = 0.014	62.1 ± 30.7	P = 0.002	66.0 ± 29.0	P = 0.001
PSF12 score	36.9 ± 9.1	43.5 ± 9.4	P = 0.036	48.2 ± 9.2	P = 0.003	49.5 ± 7.7	P < 0.001
MSF12 score	45.7 ± 12.1	54.5 ± 10.3	P = 0.008	55.7 ± 9.3	P = 0.001	56.3 ± 7.7	P = 0.002

IKDC: International Knee Documentation Committee; KOOS: Knee Injury and Osteoarthritis Outcome Score; QoL: Quality of life; ADL: Activities of daily living.