Meniscal Allograft Transplantation Is an Effective Treatment in Patients Older Than 50 Years but Yields Inferior Results Compared With Younger Patients: A Case-Control Study

Stefano Zaffagnini, Alberto Grassi, Luca Macchiarola, Federico Stefanelli, Vito Coco, Maurilio Marcacci, Luca Andriolo, Giuseppe Filardo

Research output: Contribution to journalArticle

Abstract

PURPOSE: To evaluate the influence of age on midterm clinical outcomes and failures of meniscal allograft transplantation (MAT), aiming at investigating the efficacy of MAT in patients older than 50 years.

METHODS: In this case-control study, data on patients older than 50 years (older MAT [O-MAT] group) with at least 5 years of follow-up and a matched-pair group of patients younger than 30 years of age (younger MAT [Y-MAT] group) were extracted from a database of MAT procedures, performed with arthroscopic implantation of fresh-frozen meniscal allograft without bone plugs.

RESULTS: A matched-pair comparative analysis of midterm results and survival between 26 O-MAT patients and 26 Y-MAT patients was performed at a mean follow-up of 7.3 ± 2.2 years. All the clinical scores significantly improved from the baseline values in both the O-MAT and Y-MAT groups although with significantly lower scores in the O-MAT group. Two-thirds of O-MAT patients were able to return to a recreational level of sports activity. Only 2 patients in the O-MAT group underwent knee replacement, but the overall failure rate, also considering a clinical criterion, was 31% in the O-MAT group and 15% in the Y-MAT group (P = .3244). The mean survival time free from replacement or graft removal was 11.6 years in the O-MAT group and 12.3 years in the Y-MAT group (P = .691).

CONCLUSIONS: MAT is able to provide symptom relief and functional improvement at midterm follow-up in patients older than 50 years although with inferior results and a higher failure rate compared with those younger than 30 years. MAT can be considered a viable option to treat patients older than 50 years.

LEVEL OF EVIDENCE: Level III, case-control study.

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