Kshamata D Skeete MD, Abstract Co-Author: Nothing to Disclose

Scot Elliot Campbell MD, Abstract Co-Author: Nothing to Disclose

Jessica L. Abbott DO, Presenter: Nothing to Disclose

Craig R Ruder MD, Abstract Co-Author: Nothing to Disclose

The purposes of this study are: 1. To the evaluate the change in imaging appearance of meniscal allografts over time. 2. To identify typical sites and risk factors for graft failure. 3. To evaluate for chondroprotective effects of meniscal transplantation. 4. To correlate the imaging appearance of meniscal allografts with clinical outcomes.

12 patients underwent meniscal allograft placement between August 2004 and July 2006. Each patient underwent magnetic resonance imaging preoperatively, postoperatively, then at six weeks, three months, six months, and 12 months post allograft placement. Images were assessed for incorporation of bone plugs, the status of the graft, graft extrusion, graft shrinkage, and the status of the articular cartilage on each examination. Cartilage was scored using a modified Outerbridge scale. Clinical outcomes were measured utilizing the Lysholm Scoring Scale and the Knee Outcome Survey Activities of Daily Living Scale at each follow-up visit.

All patients demonstrated incorporation of bone plugs by 12 months post surgery. Graft extrusion was present on 8/12 at initial postoperative imaging. Two patients subsequently developed extrusion due to graft failure. Progressive graft degeneration occurred at the root attachments in 8/12. When graft failure occured, it was always at the root attachment. In 6/12, there was no change in the Outerbridge score for the articular cartilage over 12 months of follow-up imaging. In 3/12 patients, there was slight progression of chondral injury on the side of meniscal allograft during the study period. In 3/12, there was mild progression of chondral injury in other areas of the knee. Average clinical outcomes scores showed gradual, slight improvement, without statistically significant correlation with bone plug incorporation, meniscal extrusion, or chondral degeneration.

Meniscal allografts commonly show degeneration at their root attachments. When graft failure occurs, it is typically at the root attachments. There appears to be a slight chondroprotective effect of meniscal allograft. Clinical outcome scores may not correlate well with imaging findings after meniscal allograft.

The imaging appearance of meniscal allografts over time is demonstrated, and correlated with clinical outcome.

Skeete, K, Campbell, S, Abbott, J, Ruder, C, Magnetic Resonance Imaging of Postoperative Meniscal Allografts and Correlation with Clinical Outcomes.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8017060.html