2024, Number 5
<< Back
Acta Ortop Mex 2024; 38 (5)
Lateral meniscus transplantation with allograft, a good alternative for the management of postmeniscectomy syndrome in young patients. Presentation of a case
Zárate-de TM, Gómez-Mont-Landerreche J, Torres-Valdés R
Language: Spanish
References: 19
Page: 351-357
PDF size: 366.58 Kb.
ABSTRACT
Meniscal injuries represent one of the main causes of intra-articular knee pain, especially in young patients, athletes or those with a high demand for physical activity; representing a challenge for the arthroscopist surgeon due to the great complexity that some of these injuries can present. Currently, the advances that have been implemented in arthroscopy allow us to repair meniscal injuries that in the past were considered irreparable. Although our priority is to preserve as much of the meniscus as possible, there are cases in which the injury reaches such complexity that this is impossible, with partial or total meniscectomy being the only therapeutic option. In the United States, approximately 690,000 partial meniscectomies are performed each year. This situation makes us consider meniscal transplantation as a great therapeutic option for patients considered young enough for joint replacement. The ideal patient is a relatively young patient (between skeletal maturity and 50 years), who has a well-documented history of partial or total meniscectomy, pain well localized to the affected compartment, with failure to conservative treatment and without high-grade chondral defects. in a generalized way. We present the case of a 35-year-old male patient with a history of total meniscectomy of the right lateral meniscus seven years ago, who currently presents with a postmeniscectomy syndrome of the lateral compartment. Due to the clinical and demographic characteristics of our patient, as well as the findings in the imaging studies, meniscal transplantation with allograft represents an excellent alternative to alleviate the symptoms and slow down as much as possible the need for joint replacement as a definitive treatment.
REFERENCES
Fox AJS, Wanivenhaus F, Burge AJ, Warren RF, Rodeo SA. The human meniscus: a review of anatomy, function, injury, and advances in treatment: The Meniscus: Anatomy, Function, Injury and Treatment. Clin Anat. 2015; 28(2): 269-87.
Musahl V, Citak M, O'Loughlin PF, Choi D, Bedi A, Pearle AD. The effect of medial versus lateral meniscectomy on the stability of the anterior cruciate ligament-deficient knee. Am J Sports Med. 2010; 38(8): 1591-7.
Katano H, Koga H, Ozeki N, Otabe K, Mizuno M, Tomita M, et al. Trends in isolated meniscus repair and meniscectomy in Japan, 2011-2016. J Orthop Sci. 2018; 23(4): 676-81.
Cullen KA, Hall MJ, Golosinskiy A. Ambulatory surgery in the United States, 2006. Natl Health Stat Report. 2009; (11): 1-25.
McDermott ID, Amis AA. The consequences of meniscectomy. J Bone Joint Surg Br. 2006; 88(12): 1549-56.
Vundelinckx B, Bellemans J, Vanlauwe J. Arthroscopically assisted meniscal allograft transplantation in the knee: a medium-term subjective, clinical, and radiographical outcome evaluation: A medium-term subjective, clinical, and radiographical outcome evaluation. Am J Sports Med. 2010; 38(11): 2240-7.
Myers P, Tudor F. Meniscal allograft transplantation: how should we be doing it? A systematic review. Arthroscopy. 2015; 31(5): 911-25.
Barlow T, Coco V, Shivji F, Grassi A, Asplin L, Thompson P, et al. Meniscal allograft transplants: state of the art. Bone Joint J. 2022; 104-B(6): 657-62.
Matava MJ. Meniscal allograft transplantation: a systematic review. Clin Orthop Relat Res. 2007; 455: 142-57.
Chambers HG, Chambers RC. The natural history of meniscus tears. J Pediatr Orthop. 2019; 39(Issue 6, Supplement 1 Suppl 1): S53-5.
Jarraya M, Roemer FW, Englund M, Crema MD, Gale HI, Hayashi D, et al. Meniscus morphology: does tear type matter? A narrative review with focus on relevance for osteoarthritis research. Semin Arthritis Rheum. 2017; 46(5): 552-61.
Bland-Sutton J. Ligaments: their nature and morphology. Reino Unido: Lewis, 1887. p. 15.
Bhan K. Meniscal tears: current understanding, diagnosis, and management. Cureus. 2020; 12(6): e8590.
Sihvonen R, Paavola M, Malmivaara A, Itala A, Joukainen A, Nurmi H, et al. Arthroscopic partial meniscectomy versus placebo surgery for a degenerative meniscus tear: a 2-year follow-up of the randomised controlled trial. Ann Rheum Dis. 2018; 77(2): 188-95.
Kellgren J, Lawrence J. Radiological assessment of osteoarthritis. Ann Rheum Dis. 1957; 16(4): 494-502.
Southworth TM, Naveen NB, Tauro TM, Chahla J, Cole BJ. Meniscal allograft transplants. Clin Sports Med. 2020; 39(1): 93-123.
Johnson DL, Swenson TM, Livesay GA, Aizawa H, Fu FH, Harner CD. Insertion-site anatomy of the human menisci: gross, arthroscopic, and topographical anatomy as a basis for meniscal transplantation. Arthroscopy. 1995; 11(4): 386-94.
Berlet GC, Fowler PJ. The anterior horn of the medical meniscus. An anatomic study of its insertion. Am J Sports Med. 1998; 26(4): 540-3.
Abat F, Gelber PE, Erquicia JI, Tey M, Gonzalez-Lucena G, Monllau JC. Prospective comparative study between two different fixation techniques in meniscal allograft transplantation. Knee Surg Sports Traumatol Arthrosc. 2013; 21(7): 1516-22.