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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Allografts
Case-Control Studies
Transplantation
Therapeutics
Matched-Pair Analysis
Sports
Knee
Research Design
Survival Rate
Databases
Transplants
Bone and Bones
Survival

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@article{bb77e77d6056470b9e377c8e989a2e9f,
title = "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",
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.",
author = "Stefano Zaffagnini and Alberto Grassi and Luca Macchiarola and Federico Stefanelli and Vito Coco and Maurilio Marcacci and Luca Andriolo and Giuseppe Filardo",
note = "Copyright {\circledC} 2019. Published by Elsevier Inc.",
year = "2019",
month = "8",
doi = "10.1016/j.arthro.2019.03.048",
language = "English",
volume = "35",
pages = "2448--2458",
journal = "Arthroscopy - Journal of Arthroscopic and Related Surgery",
issn = "0749-8063",
publisher = "W.B. Saunders Ltd",
number = "8",

}

TY - JOUR

T1 - 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

AU - Zaffagnini, Stefano

AU - Grassi, Alberto

AU - Macchiarola, Luca

AU - Stefanelli, Federico

AU - Coco, Vito

AU - Marcacci, Maurilio

AU - Andriolo, Luca

AU - Filardo, Giuseppe

N1 - Copyright © 2019. Published by Elsevier Inc.

PY - 2019/8

Y1 - 2019/8

N2 - 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.

AB - 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.

U2 - 10.1016/j.arthro.2019.03.048

DO - 10.1016/j.arthro.2019.03.048

M3 - Article

VL - 35

SP - 2448

EP - 2458

JO - Arthroscopy - Journal of Arthroscopic and Related Surgery

JF - Arthroscopy - Journal of Arthroscopic and Related Surgery

SN - 0749-8063

IS - 8

ER -