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Meniscal allograft transplantation in The Netherlands: long-term survival, patient-reported outcomes, and their association with preoperative complaints and interventions
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 tr...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591451/ https://www.ncbi.nlm.nih.gov/pubmed/32979080 http://dx.doi.org/10.1007/s00167-020-06276-y |
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author | van der Wal, Robert J. P. Nieuwenhuijse, Marc J. Spek, Reinier W. A. Thomassen, Bregje J. W. van Arkel, Ewoud R. A. Nelissen, Rob. G. H. H. |
author_facet | van der Wal, Robert J. P. Nieuwenhuijse, Marc J. Spek, Reinier W. A. Thomassen, Bregje J. W. van Arkel, Ewoud R. A. Nelissen, Rob. G. H. H. |
author_sort | van der Wal, Robert J. P. |
collection | PubMed |
description | 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). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00167-020-06276-y) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7591451 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-75914512020-10-29 Meniscal allograft transplantation in The Netherlands: long-term survival, patient-reported outcomes, and their association with preoperative complaints and interventions van der Wal, Robert J. P. Nieuwenhuijse, Marc J. Spek, Reinier W. A. Thomassen, Bregje J. W. van Arkel, Ewoud R. A. Nelissen, Rob. G. H. H. Knee Surg Sports Traumatol Arthrosc Knee 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). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00167-020-06276-y) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-09-26 2020 /pmc/articles/PMC7591451/ /pubmed/32979080 http://dx.doi.org/10.1007/s00167-020-06276-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Knee van der Wal, Robert J. P. Nieuwenhuijse, Marc J. Spek, Reinier W. A. Thomassen, Bregje J. W. van Arkel, Ewoud R. A. Nelissen, Rob. G. H. H. Meniscal allograft transplantation in The Netherlands: long-term survival, patient-reported outcomes, and their association with preoperative complaints and interventions |
title | Meniscal allograft transplantation in The Netherlands: long-term survival, patient-reported outcomes, and their association with preoperative complaints and interventions |
title_full | Meniscal allograft transplantation in The Netherlands: long-term survival, patient-reported outcomes, and their association with preoperative complaints and interventions |
title_fullStr | Meniscal allograft transplantation in The Netherlands: long-term survival, patient-reported outcomes, and their association with preoperative complaints and interventions |
title_full_unstemmed | Meniscal allograft transplantation in The Netherlands: long-term survival, patient-reported outcomes, and their association with preoperative complaints and interventions |
title_short | Meniscal allograft transplantation in The Netherlands: long-term survival, patient-reported outcomes, and their association with preoperative complaints and interventions |
title_sort | meniscal allograft transplantation in the netherlands: long-term survival, patient-reported outcomes, and their association with preoperative complaints and interventions |
topic | Knee |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591451/ https://www.ncbi.nlm.nih.gov/pubmed/32979080 http://dx.doi.org/10.1007/s00167-020-06276-y |
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