• Philipp W Winkler, Nyaluma N Wagala, Jonathan D Hughes, and Volker Musahl.
• Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, 3200 S. Water St, Pittsburgh, PA, 15203, USA.
• Arch Orthop Trauma Surg. 2023 Jan 1; 143 (1): 399407399-407.

IntroductionPreoperatively available predictors of meniscal allograft failure would help in patient counseling and surgical indication for meniscal allograft transplantation (MAT). It was hypothesized that young patient age, high posterior tibial slope (PTS), and high-grade osteoarthritis (OA) are predictors of meniscal allograft failure.Materials And MethodsPatients undergoing MAT with a minimum follow-up of 2 years were included in this retrospective study. Demographic and surgical data, and causes of meniscal allograft failure were collected. PTS and degree of OA (low-grade: Kellgren-Lawrence 0, 1, and 2; high-grade: Kellgren-Lawrence 3 and 4) of the index and opposite tibiofemoral compartments were determined on preoperative radiographs.ResultsThis study included 77 patients with a mean age of 25.7 ± 10.1 years at the time of MAT. After a mean follow-up of 7.6 ± 5.6 years, meniscal allograft failure was observed in 26 patients (34%). The median time from MAT to meniscal allograft failure was 1.3 years (inter-quartile range, 2.5 years). Meniscal allograft tears (88%) were the primary cause of graft failure, followed by high-grade OA (12%). Patients experiencing meniscal allograft failure were an average of 2.7 years (95% CI [2.2, 7.5], p = 0.202) older at the time of MAT than patients without failure. PTS was not found to be a predictor of meniscal allograft failure (odds ratio, 0.884 (95% CI [0.727, 1.073], p = 0.212)). Patients with high-grade preoperative OA of the index compartment had 28 times higher odds of experiencing meniscal allograft failure than patients with low-grade preoperative OA (p = 0.008).ConclusionsHigh-grade preoperative OA of the index compartment was found to be a significant and clinically relevant predictor of meniscal allograft failure. Surgeons should be aware of the impact of OA on meniscal allograft survival, which needs to be considered in patient counseling and surgical indication for MAT in patients.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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