Transplante de menisco en pacientes sintomáticos de menos de 50 años de edad.

Frank R. Noyes, MD1, Sue D. Barber-Westin, BS1 and Marc Rankin, MD1
1 Deaconess Hospital, 311 Straight Street, Cincinnati, OH 45219. E-mail address for S.D. Barber-Westin: sbwestin@csmref.org
Investigation performed at Cincinnati Sportsmedicine and Orthopaedic Center, Cincinnati, Ohio

Background:
The purpose of this study was to prospectively evaluate the results of meniscal transplantation in a consecutive series of younger patients treated for pain in the tibiofemoral compartment following a previous meniscectomy.

Methods:
Forty cryopreserved menisci were implanted into thirty-eight patients. Sixteen knees also had an osteochondral autograft transfer, and nine had a knee ligament reconstruction. The clinical outcome and failure rate of all transplants were evaluated at a mean of forty months postoperatively. Meniscal allograft characteristics were determined with use of a rating system that combined subjective, clinical, and magnetic resonance imaging factors.

Results:
Thirty-four (89%) of the thirty-eight patients rated the knee condition as improved. Before surgery, thirty patients (79%) had pain with daily activities, but only four (11%) had such pain at the time of the latest follow-up. While noteworthy pain was present in the tibiofemoral compartment in all forty knees before surgery, twenty-seven knees (68%) had no pain and thirteen (33%) had only mild compartment pain at the time of the latest follow-up. Twenty-nine patients (76%) returned to light low-impact sports without problems. Concomitant osteochondral autograft transfer and knee ligament reconstruction procedures improved knee function and did not increase the rate of complications. Meniscal allograft characteristics were normal in seventeen knees (43%), altered in twelve (30%), and failed in eleven (28%).

Conclusions:
The short-term results of meniscal transplantation are encouraging in terms of reducing knee pain and increasing function; however, long-term transplant function and any chondroprotective effects remain unknown and require further investigation.

The Journal of Bone and Joint Surgery (American) 86:1392-1404 (2004).

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