Meniscal Allograft Transplantation Reoperation Rates, Operative Findings, and Survival Analysis: A Review of 200 Consecutive Transplants at Minimum Two-year Follow-up

OBJECTIVES: Reoperation rates for meniscal allograft surgery (MAT) are high with a 70% survival rate at 10 years. The indications and findings for secondary surgery are not well characterized. The purpose of this study is to quantify the percentage of transplants requiring a re-operation, to characterize the operative findings, perform a survival analysis, and perform a case-control analysis if an early return to surgery is predictive of failure. METHODS: A retrospective review of prospectively collected data from a single-surgeon was performed. Inclusion period was 2003-2011.. The number of patients returning to the OR and the findings at surgery were recorded. A meniscal transplant survival curve, the duration between transplantation and return to OR, and an odds-ratio of risk for failure for those requiring a re-operation in the perioperative period were calculated. RESULTS: Two hundred patients underwent a MAT during the study period. 38% were isolated; 62% had concomitant procedures. Sixty-four (32%) patients returned to the operating room, of which 38 (59%) were for a meniscal? debridement. The mean duration to secondary surgery was 21 months, with 73% within 2 years. One hundred seventy-two (86%) patients were evaluated at a mean 59 months (Range 24-118 months). Eight went on to require a revision MAT or total knee replacement (4.7%). Patients requiring secondary surgery within two years had an 8.4 odds-ratio for future failure (95% CI 1.6-43.4 p.007). CONCLUSION: In the largest consecutive series reported in the literature, meniscal allograft transplantation (MAT) has a 95% success rate a mean of approximately five years. There is a 32% reoperation rate, with meniscal debridement the most common secondary surgical treatment.