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

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 50years. In this case-control study, data on patients older than 50years (older MAT [O-MAT] group) with at least 5years of follow-up and a matched-pair group of patients younger than 30years 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. 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 ± 2.2years. 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 11.6years in the O-MAT group and 12.3years in the Y-MAT group (P= .691). MAT is able to provide symptom relief and functional improvement at midterm follow-up in patients older than 50years although with inferior results and a higher failure rate compared with those younger than 30years. MAT can be considered a viable option to treat patients older than 50years. Level III, case-control study.