The American journal of sports medicine
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Allograft meniscal transplantation is known as a possible procedure to solve pain and loss of function in the knee of patients with a history of subtotal or total meniscectomy. ⋯ Meniscal allograft transplantation may result in important pain relief and functional improvement in patients with a history of (sub)total meniscectomy and pain localized in the affected compartment. Strictly following the indications, meniscal transplantation can give good and predictable results. In 58% of patients, there was no increase in osteoarthritis according to the Kellgren-Lawrence classification. In 42%, there was a slight or moderate increase in osteoarthritis. No severe increase was noted.
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The medial patellofemoral ligament (MPFL) is the primary restraint to extreme lateral displacement and is typically disrupted with an acute lateral patellar dislocation. Patients who fail a comprehensive nonoperative program and experience recurrent lateral patellar instability episodes are candidates for surgical treatment. Current surgical procedures include a variety of proximal realignment techniques, including repair or reconstruction of the MPFL along with distal realignment of the tibial tubercle when indicated. ⋯ Isolated repair of the MPFL for recurrent patellar instability is associated with a relatively high failure rate, but remains a viable surgical option if surgical technique principles are followed. The clinical success of this operation depends on restoration of the anatomical origin of the MPFL and careful patient selection.