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Capsular fixation limits graft extrusion in lateral meniscal allograft transplantation.
Int Orthop 2019IO

Abstract

PURPOSE

The main purpose of this investigation was to compare the amount of graft extrusion of lateral meniscal allograft transplantation (MAT) performed with a suture-only technique with or without a capsulodesis. Secondarily, the assessment of functional results was also covered. We hypothesized that capsular fixation reduces the post-operative degree of allograft extrusion and it does not affect the functional outcomes during the short-term follow-up period studied.

METHODS

Prospective series of 29 lateral MAT. Fifteen were fixed with a suture-only technique (group A). The remaining 14 cases (group B) also included arthroscopic lateral capsular fixation (capsulodesis). Functional results were assessed with Lysholm, Tegner, and VAS for pain. Magnetic resonance imaging (MRI) was performed to determine the degree of meniscal extrusion. Millimeters of extrusion and percentage of extruded meniscal tissue were calculated for both groups. The degree of extrusion was considered minor if it was < 3 mm or major if it was > 3 mm.

RESULTS

Group A had 11 cases (73.3%) of major extrusion and group B had 4 cases (28.6%) (p = 0.02). The percentage of extruded meniscal tissue was 35% in group A and 24.6% in group B (p = 0.04). At a mean 3.4 years (range 1-4) post-operatively, the Lysholm score had a mean 89.60 ± 6.93 and 91.43 ± 6.19 points in groups A and B, respectively (p < 0.001). The median follow-up Tegner score improved from 4 (range 3-5) to 7 (range 6-9) in group A (p < 0.001) and from 4 (range 3-5) to 7 (range 6-8) in group B (p < 0.001). VAS dropped 5 and 7.3 points in groups A and B, respectively (p < 0.001). There were no complications in this series.

CONCLUSIONS

In lateral MAT with the suture-only fixation technique, the described capsulodesis minimized meniscal extrusion. In terms of functional results, there were no differences between the groups at a mean 3.4-year follow-up.

Authors+Show Affiliations

Department of Orthopedic Surgery and Traumatology, ICATME, Hospital Universitari Dexeus - Universitat Autònoma de Barcelona, Sabino Arana, 5-19, 08028, Barcelona, Spain.Department of Orthopedic Surgery and Traumatology, ICATME, Hospital Universitari Dexeus - Universitat Autònoma de Barcelona, Sabino Arana, 5-19, 08028, Barcelona, Spain. Department of Orthopaedic Surgery, Parc de Salut Mar - Universitat Autònoma de Barcelona, Barcelona, Spain.ReSport Clinic, Barcelona, Spain.Department of Orthopedic Surgery and Traumatology, ICATME, Hospital Universitari Dexeus - Universitat Autònoma de Barcelona, Sabino Arana, 5-19, 08028, Barcelona, Spain. personal@drgelber.com. Department of Orthopaedic Surgery, Hospital de la Santa Creu i Sant Pau - Universitat Autònoma de Barceloba, Barcelona, Spain. personal@drgelber.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31444564

Citation

Masferrer-Pino, Angel, et al. "Capsular Fixation Limits Graft Extrusion in Lateral Meniscal Allograft Transplantation." International Orthopaedics, 2019.
Masferrer-Pino A, Monllau JC, Abat F, et al. Capsular fixation limits graft extrusion in lateral meniscal allograft transplantation. Int Orthop. 2019.
Masferrer-Pino, A., Monllau, J. C., Abat, F., & Gelber, P. E. (2019). Capsular fixation limits graft extrusion in lateral meniscal allograft transplantation. International Orthopaedics, doi:10.1007/s00264-019-04398-8.
Masferrer-Pino A, et al. Capsular Fixation Limits Graft Extrusion in Lateral Meniscal Allograft Transplantation. Int Orthop. 2019 Aug 23; PubMed PMID: 31444564.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Capsular fixation limits graft extrusion in lateral meniscal allograft transplantation. AU - Masferrer-Pino,Angel, AU - Monllau,Joan C, AU - Abat,Ferran, AU - Gelber,Pablo E, Y1 - 2019/08/23/ PY - 2019/06/03/received PY - 2019/08/15/accepted PY - 2019/8/25/entrez KW - Capsulodesis KW - Knee KW - Meniscal extrusion KW - Meniscal transplantation KW - Meniscus JF - International orthopaedics JO - Int Orthop N2 - PURPOSE: The main purpose of this investigation was to compare the amount of graft extrusion of lateral meniscal allograft transplantation (MAT) performed with a suture-only technique with or without a capsulodesis. Secondarily, the assessment of functional results was also covered. We hypothesized that capsular fixation reduces the post-operative degree of allograft extrusion and it does not affect the functional outcomes during the short-term follow-up period studied. METHODS: Prospective series of 29 lateral MAT. Fifteen were fixed with a suture-only technique (group A). The remaining 14 cases (group B) also included arthroscopic lateral capsular fixation (capsulodesis). Functional results were assessed with Lysholm, Tegner, and VAS for pain. Magnetic resonance imaging (MRI) was performed to determine the degree of meniscal extrusion. Millimeters of extrusion and percentage of extruded meniscal tissue were calculated for both groups. The degree of extrusion was considered minor if it was < 3 mm or major if it was > 3 mm. RESULTS: Group A had 11 cases (73.3%) of major extrusion and group B had 4 cases (28.6%) (p = 0.02). The percentage of extruded meniscal tissue was 35% in group A and 24.6% in group B (p = 0.04). At a mean 3.4 years (range 1-4) post-operatively, the Lysholm score had a mean 89.60 ± 6.93 and 91.43 ± 6.19 points in groups A and B, respectively (p < 0.001). The median follow-up Tegner score improved from 4 (range 3-5) to 7 (range 6-9) in group A (p < 0.001) and from 4 (range 3-5) to 7 (range 6-8) in group B (p < 0.001). VAS dropped 5 and 7.3 points in groups A and B, respectively (p < 0.001). There were no complications in this series. CONCLUSIONS: In lateral MAT with the suture-only fixation technique, the described capsulodesis minimized meniscal extrusion. In terms of functional results, there were no differences between the groups at a mean 3.4-year follow-up. SN - 1432-5195 UR - https://www.unboundmedicine.com/medline/citation/31444564/Capsular_fixation_limits_graft_extrusion_in_lateral_meniscal_allograft_transplantation L2 - https://dx.doi.org/10.1007/s00264-019-04398-8 DB - PRIME DP - Unbound Medicine ER -