Clinical Evaluation using MRI and Arthroscopy after Meniscal Transplantation

Seung Hyun Cho; Jin Goo Kim

doi:10.4055/jkoa.2007.42.1.77

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Cho and Kim: Clinical Evaluation using MRI and Arthroscopy after Meniscal Transplantation

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(1): 77-83.

Published online: 28 February 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.1.77

Clinical Evaluation using MRI and Arthroscopy after Meniscal Transplantation

Seung Hyun Cho, M.D., Jin Goo Kim, M.D.

Department of Orthopedic Surgery, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea.

Address reprint requests to Jin Goo Kim, M.D. Department of Orthopedic Surgery, Seoul Paik Hospital, College of Medicine, Inje University, 85, Jeo-dong 2-ga, Jung-gu, Seoul, Korea. Tel: +82.2-2270-0028, Fax: +82.2-2270-0023, borami107@hanmail.net

Abstract

Purpose

To evaluate the status of transplanted menisci using MRI and arthroscopy.

Materials and Methods

Between March 1998 and October 2004, twenty three patients underwent a meniscal transplant at our institution. Twenty-one out of 23 patients were available for follow-up and were evaluated an average of 44 months (range, 19 to 87 months). Four allografts were medial and 17 were lateral. There were 17 men and 4 women with ages ranging from 16 to 47 years (mean, 29.6 years). The clinical outcomes were evaluated using the Lysholm score, the International Knee Documentation Committee (IKDC) subjective score and the modified Hospital for Special Surgery (HSS) score. MRI and arthroscopic examinations were performed in 18 and 11 patients respectively.

Results

The average Lysholm score improved from 60.6 to 85.7, and that of the IKDC subjective score and modified HSS score (knee score/functional score) was 79.5 and 88/93 respectively. Six of the eleven knees that underwent the arthroscopic examinations were confirmed to be normal. The MRI evaluation revealed all the allografts to have healed completely but there was degeneration/shrinkage of the allografts, and injuries to the surrounding articular cartilage. Extrusion or subluxation of the menisci was observed in all cases.

Conclusion

Meniscal transplantation may be an effective procedure for young and active patients suffering from pain after a meniscectomy with minimal degenerative changes. However, a partial tear, extrusion or subluxation of the allograft menisci and a progression of degenerative arthritis have been reported. Therefore, more accurate and reliable surgical techniques as well as a long-term follow-up are recommended.

Keywords: Meniscal transplantation, Arthroscopic examination, Extrusion or subluxation, MRI

Figures and Tables

Fig. 1

MR image of the lateral meniscus showing the extrusion of the transplanted lateral meniscus.

Table 1

Summary of Cases

^*Interval, time from the transplant to the MRI study; ^†OCD, osteochondritis dissecans; ^‡ACL, anterior cruciate ligament; ^§PCL, posterior cruciate ligament.

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