The biomechanical role of meniscal allograft transplantation and preliminary in-vivo kinematic evaluation

Abstract

Background: Meniscus allograft transplantation (MAT) is a surgical procedure performed in patients complaining post-meniscectomy syndrome. Although the effectiveness of MAT on knee stability has been already demonstrated in cadaveric studies, its biomechanical role has been poorly evaluated in-vivo.

Methods: A narrative review of the biomechanical effect of meniscectomy and MAT was performed. Furthermore, two cases were presented, of one patient who underwent Medial MAT and Anterior Cruciate Ligament (ACL) reconstruction, and one who underwent Lateral MAT. During the surgery, knee laxity was evaluated using a surgical navigation system.

Results: AP laxity and IE rotation were reduced of 25% to 50% at both 30° and 90° of knee flexion after MAT transplantation.

Discussion: In both cases, almost all the tests performed showed a reduction of knee laxity after meniscus transplant, when compared with pre-operative knee laxity. This assessment confirms the insights of previous in-vitro studies and underline a crucial role of MAT in knee biomechanics.

Keywords: Biomechanical evaluation; Knee; Laxity test; Meniscus; Meniscus allograft transplantation.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1

Pre-operative AP knee radiography Patient 1

Fig. 2

A recent frontal (a) and sagittal (b) MRI Patient 1

Fig. 3

Arthroscopic evaluation: (a) Pre-operative and (b) after medial MAT Patient 1

Fig. 4

Laxity evaluation: AP30 and AP90 (a), IE30 and IE90 (b), VV0 and VV30 (c) for Medial MAT

Fig. 5

Pre-operative AP knee radiography Patient 2

Fig. 6

A recent frontal (a) and sagittal (b) MRI Patient 2

Fig. 7

Arthroscopic evaluation: (a) Pre-operative and (b) after lateral MAT Patient 2

Fig. 8

Laxity evaluation: AP30 and AP90 (a), IE30 and IE90 (b), VV0 and VV30 (c) for Lateral MAT